Obesity Surgery Center Bursa
Obesity Surgery is a low-risk surgery when it is performed to the right patient by qualified hospitals and experienced surgeons. Information was shared with Bursa Obesity Surgeons, and surgical techniques with live surgery were demonstrated by Doctors performing Bursa Obesity Surgery.
Obesity is one of the biggest health problems in the world, especially in western societies. In many scientific studies, obesity has been shown as the most important cause of many diseases that increase mortality and morbidity. The most commonly used measurement method for obesity is BMI (Body Mass Index). It is the value obtained by dividing the weight by the square of the neck.
18.5-24.9 kg / m2 Normal individuals
25-29.9 kg / m2 Overweight
30-40 kg / m2 <Obese
40 kg / m2 <Morbid obese
However, increasing BMI may not always mean obesity. In people with excess muscle tissue, the body mass index may be high. Expert evaluation is important to understand the source of increases in body weight. Obesity should be considered if waist circumference is 102 cm in men and 88 cm in women.
The main purpose of performing obesity surgery is to prevent the development of obesity-induced diseases (DM, cardiovascular diseases, sleep apnea syndrome, etc.) as well as weight loss. To treat diseases if they occur.
It can cause obesity alone or in combination with many factors. These include genetic predisposition, endocrine and metabolic diseases, social and cultural differences. Basically, the amount of energy entering the body exceeds the amount burned causes obesity.
It is estimated that around 1.7 billion people are overweight individuals worldwide. In the United States, the situation is more serious. About 2/3 of the population is overweight and about half of them are classified as obese.
Morbid obesity is a fatal disease and a “vital rahatsızlık condition that must be remedied. It is thought that the average life expectancy of those who underwent morbid obesity surgery is 15 years.
Who is Obesity Surgery Applied?
Diet: Patients who are planned to undergo surgical treatment are those who do not have any hormonal disturbances and who fail to lose weight with diet, exercise and medication, or regain weight. These patients should have obesity problems for at least 3 years and have failed twice in at least 6 months despite dietary exercise and psychological support. Although these patients have a 2-4% chance of losing weight with diet and exercise, they should be tried before recommending surgery.
Age: The patient should be between 18-65 years old. This age limitation may include exceptions depending on the patient’s performance and comorbidities.
Body Mass Index: The body mass index should be over 40 or between 35-40 and there should be co-morbidities (high blood pressure, diabetes, sleep apnea, joint disorders, reflux disease, etc.).
The World Health Organization recommends that surgical treatment is the most effective treatment for obesity and comorbidities in patients with BMI> 35 kg / m2 in the presence of one or more comorbidities and in patients with BMI> 40 kg / m2 in the absence of any coexisting findings.
The American Diabetes Association and the International Diabetes Federation (type 2) have shown that obesity surgery is superior to any treatment in patients receiving treatment for type 2 diabetes and whose blood sugar levels are uncontrolled despite the treatment and whose body mass index is greater than 35 kg / m2. they are telling.
Addiction and Psychiatric Disorder: The patient who is going to undergo an obesity operation should not be addicted to alcohol or drugs, but at the same time must be at a psychological level to accept the risks and follow-up and nutritional conditions of the surgery.
Pregnancy and Childbirth: It is recommended not to become pregnant for 24 months after obesity surgery.
OBESITY SURGERY TYPES
Obesity surgery methods can be roughly divided into three
Restrictive surgeries; They are surgeries that restrict food intake by reducing stomach volume. Gastric band and tube stomach surgeries are among this group operations.
Surgery that reduces food absorption or both restricts and reduces absorption; These operations are generally called bypass surgeries. In these surgeries, parts of the small intestine of varying length are separated from the passage of food. This prevents the body from taking up a significant portion of the calories taken. Mini Gastric Bypass, R-Y Gastric Bypass, Biliopancreatic Diversion / Duodenal Switch, Duodenojejunal Bypass / Sleeve Gastrectomy are among these operations.
Because it is easier, it can be applied in a shorter time, and the risk is partially less, the most commonly used mobite obesity surgery is tube gastric surgery.
To be applied to the operation of the patient;
Body mass index
It should be determined according to feeding habits.
OBESITY SURGERY TREATMENT
In the treatment of obesity surgery, cause oriented treatment should be applied. If there is a metabolic cause that causes obesity, it should be treated first. Appropriate diet, exercise, medication, psychological support and other treatment methods should be planned for the patient. The patient should undergo detailed analysis and determine whether obesity is due to any organic cause (genetics, endocrine, neurological) or drug use.
First, a personalized diet and exercise program should be planned by a professional team. If necessary, drug treatment should be initiated. However, in spite of all efforts, only 2-4% of long-term morbidly obese patients can lose weight permanently. In other obese groups, gastric balloon placement or morbid obesity surgery is a life-saving procedure.
The misperception in our society is that these initiatives are purely aesthetic. However, if they do not have surgery, they are actually in the grip of a fatal disease, and most of them (if not treated) are lost at a young age.
Morbid obesity is a very serious disease that shortens life and the most effective treatment scientifically proven is possible with bariatric surgery, that is, obesity surgery. Thanks to bariatric surgery, these people can live longer and healthier up to 10-15 years.
Obesity surgery has been widely performed in the world in recent years. The first effective obesity surgery was performed in 1954 by Kremen and Linner (jejunaileal bypass) in the United States.
The operations are divided into 3 according to the mechanism of action;
Restrictive Surgery (adjustable gastric banding, sleeve gastrectomy)
Restrictive and Absorbing Combined Operations (duodenal switch, SADI-S)
Who Should Treat Obesity Surgery?
We select the patients who are suitable for obesity surgery surgery according to the following criteria.
Body mass index is above 40 or between 35-40 and there is concomitant disease (hypertension, diabetes mellitus, sleep apnea, arthritis)
Obesity has been present for at least 3 years
Absence of hormonal diseases (Hypothyroidism, adrenal gland diseases)
Inability to lose weight for at least 1 year despite drug and diet therapy
Not being addicted to alcohol or drugs
The patient should understand the method to be applied and be able to adapt after surgery
Intragastric Balloon Application (Stomach Balloon Application)
In the treatment of obesity, endoscopic procedures are available as well as surgical procedures. Among them, the most commonly used Intragastric Balloon (Stomach Balloon) is the application.
Who can do Stomach Balloon Application?
It can be applied to anyone who can tolerate endoscopy.
It can be applied to patients who cannot tolerate surgery, patients with hiatal hernia (gastric hernia) and stomach ulcers larger than 3 cm, patients with previous gastric surgery, psychiatric disease and alcohol and drug addiction.
-When major surgery is performed in patients with BMI (BMI) 40 and above and BMI (BMI) 35 and additional disease, in order to weaken the preoperative patients and reduce the risk of complications and death,
– BMI (BMI) is applied to patients who cannot lose weight despite diet and exercise programs over 30 kg / m2.
Stomach Balloon Method is not operated.
Stomach Balloon Procedure is performed in the endoscopy unit under sedoanalgesia in 15-20 minutes.
In the gastric balloon procedure, patients stay in the hospital for 1 day and are provided with food in the early postoperative period.
Thanks to the newly developed balloons (Adjustable Stomach Balloon System), the patient has the possibility of staying in the stomach balloon for 1 year.
It is possible to lose 30-50 kg of controlled weight in 1 year thanks to proper diet and exercise programs.
The balloon can be inflated by means of the Adjustable Stomach Balloon System in patients who are deemed to have lost weight or stopped during a one-year period.
After the old balloon is removed, if the patient wishes, the new balloon can be put back into the stomach.
It is more economical than bariatric surgery.