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SLEEVE GASTRECTOMY

SLEEVE GASTRECTOMY

What is sleeve gastrectomy?

It is a weight loss surgery that gained remarkable popularity recently.

This procedure limits the food intake by reducing the capacity of stomach approximately by 75-80% in order to help long-term weight loss. Moreover, it decreases the appetite by decreasing the release ghrelin hormone, also known as the "appetite hormone”, which is responsible for provoking the feeling of hunger, and it also helps the patient to feel full earlier than usual. Because the ghrelin is mostly secreted from the removed portion of stomach.

Tüp Mide (Sleeve Gastrektomi)

How does sleeve gastrectomy act?

The effect is based on deactivating a substantial part of the stomach. Since your stomach will lose a major part of its capacity, it will only be able to contain a small amount of food. You will feel completely full with less food and feel less hunger during the interval between meals.

Sleeve gastrectomy also involves removal of the portion that produces ghrelin hormone, which triggers hunger. This results in decreased appetite.

Weight loss starts immediately after the surgery. It will last up to 24 months. Meanwhile, it is important to maintain a reasonable size of serving. You will not feel hungry, provided you strictly comply to the recommended diet.

sleeve-gastrectomy

Is sleeve gastrectomy a good option for me?

Sleeve gastrectomy is a good option if;

Your BMI (Body Mass Index) score is 40 or above

Your BMI score is 35 or higher and you have other medical conditions such as type 2 diabetes mellitus or hypertension

You are ready to change your lifestyle and eating habits

You tried to lose weight with diet and exercise but ended up with the same result

How sleeve gastrectomy is performed?

Patients are administered general anesthesia before the surgery. Laparoscopic technique is used and it generally takes about 1 or 1 and a half an hour. Surgery is performed by inserting surgical tools through four to five incisions, measuring 4 mm and 10 mm in length, on the abdominal skin. A guide tube is inserted into the stomach to determine how much the capacity of stomach will be reduced. Under the guidance of this tube, the stomach is incised and sutured at the same time with disposable devices called stapler. Leakage is tested, after the procedure is completed. Once verified, the excised portion of the stomach is pulled out through the incisions.

Postoperative care

You will be stay at the hospital for about 3-4 days following the surgery.

You will only be able to drink clear liquids on the first day. Next, you will switch to soft and moist foods followed by a liquid diet for several weeks and ultimately, you will add solid foods to your diet approximately four to six weeks after the surgery.

Most people may resume activities of daily life approximately 1-3 weeks after the surgery. You should consult your surgeon about when to engage in your work and start exercising.

Complications and side effects

tup-mide-ameliyati

Since it is a laparoscopic surgery, the postoperative pain will be quite low. You may vomit or feel discomfort if you eat more than the capacity of your new, small stomach. You should chew your food well, eat in smaller servings and strictly follow your diet plan.

Bleeding, embolism, pain and wound infection that are among the potential complications of any surgery also apply to this surgery, although the risk is low. Our experienced surgical team will minimize these risks by taking various preoperative and postoperative measures as well as technological opportunities. The most threatening complications of these surgeries are;

-Bleeding 0.9%

-Embolism 0.3%

-Leakage 1-2%

Your bariatric surgeon will inform you about the potential complications and side effects prior to your decision.

After sleeve gastrectomy

Diet- and eating-related expectations

Once you decide to undergo surgery, you will be advised about the necessary dietary and nutritional issues that you are expected to follow.

You will start your preoperative diet two weeks before the surgery and maintain your postoperative diet that will be modified for each phase.

Your stomach will lose its volume by about 75-80% after gastric sleeve surgery. Surgery will not only suppress your appetite, but it will also help you feel satiated with less food.

Weight loss after sleeve gastrectomy

The weight that you will lose after sleeve gastrectomy will depend on several factors, including but not limited to: Your diet, amount of exercise and your determination to change your general life style.

Patients may lose the 70-100% of the excessive weight on average in the postoperative period.

You will start losing weight as of the first day after the surgery. You may expect that the majority of the weight loss will occur in the first six months.

Once you witness the weight loss, you will be better motivated to lose more weight, eat healthily and show your amazing progression.

Losing weight may help you to be more agile and more active. Increased physical activity helps you to burn calories and lose weight.

Try to be motivated and celebrate your success in reaching your weight loss targets.

Once you achieve the optimal body weight, you should keep eating healthily to maintain your weight and avoid regaining weight.

Follow-up and support

You can attend your appointments with our bariatric team regularly. We supervise your success in losing weight and improving your health, perform tests to diagnose or rule out vitamin and mineral deficiencies, evaluate any need for support and may give you advices. We may provide you with dietary advices and tips to motivate you in your journey of weight loss.  We can also immediately detected if you are dehydrated or not.

We organize preoperative and postoperative support groups to boost behavioral awareness in patients. These groups allow patients to share their concerns, discuss them frankly, and support each other. Seminars, breakfast activities, outdoor sports activities and hiking are organized for groups at predetermined dates. We recommend you to attend these activities as much as possible.

Sleeve gastrectomy diet

If you plan to undergo sleeve gastrectomy, you should strictly follow a specific diet starting 2 weeks before the procedure. This diet aims to reduce the size and weight of your liver to facilitate the surgery. Moreover, we had observed that postoperative performance is better for patients with better compliance to the diet in the preoperative period.

Your postoperative diet will help you recover, avoid complications and adapt to your new stomach.

Success of your sleeve gastrectomy surgery will depend on your commitment to a healthy diet and lifestyle.

Our bariatric surgery team will inform you about your diet and provide support in your weight-loss journey.

Long-term postoperative dietary tips

In order to reach and maintain your weight loss targets, please follow a healthy, high-protein, low-fat, and low-calorie diet in the rest of your life.

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Nutritionist Hande Güngör

AD SOYAD

HANDE GÜNGÖR

UNVAN

DIETITIAN/NUTRITIONIST

ŞUBE

MEDICANA BURSA

TELEFON

0224 970 01 01

E-POSTA

İNFO@MEDİCANA.COM.TR

MEZUN OLDUĞU TIP FAKÜLTESİ VE YILI ULUDAĞ ÜNİV,

BASKENT UNIVERSITY FACULTY OF HEALTH SCIENCE DEPARTMENT OF NUTRITION AND DIETETICS(FULL SCHOLARSHIP) 2017

ANADOLU UNIVERSITY OPEN EDUCATION DEPARTMENT OF SOCIOLOGY 2017

UZMANLIK EĞİTİMİ ALDIĞI YER VE YILI ULUDAĞ ÜNİV.

 

MESLEKİ DENEYİM

CEYLAN INTERNATIONAL HOSPITAL (2017-2019)

GULHANE EDUCATION AND RESEARCH HOSPITAL (2017)

BASKENT UNIVERSITY ANKARA HOSPITAL (2017)

VITALIS BRANDENBURG GmbH BERLİN/ALMANYA(2016)

 

TIBBİ İLGİ ALANLARI

   PERSONEL DIET PROGRAMS (OBESITY)

   INDIVIDUAL / INSTITIONAL NUTRITION CONSULTANCY

   HEALTHY WEIGHT LOSS PROGRAMS

   NUTRITION AND WEIGHT MANAGEMENT IN                                                DIABETES AND GESTATIONAL DIABETES

  NUTRITION AND WEIGHT MANAGEMENT IN PREGNANCY

  MILK ENHANCER AND WEIGHT MANAGEMENT IN LACTATION

   NUTRITION IN CHILDHOOD AND ADOLESCENCE

   WEIGHT MANAGEMENT IN CHILDREN AND ADOLESCENTS

·         NUTRITIONAL TREATMENT IN DISEASES

·         NUTRITION IN ONCOLOGY

·         NUTRITION IN HEART AND VASCULAR DISEASES

·         NUTRITION IN KIDNEY DISEASES

·         NUTRITION IN GASTROINTESTINAL SYSTEM DISEASES

·         NUTRITION IN BARIATRIC SURGERY

·         NUTRITION IN EATING DISORDERS (ANOREXIA, BULIMIA, MALNUTRITION)

·         ENTERAL PARENTERAL NUTRITION

·         GERIATRICS NUTRITION (OVER MEDIUM AGE)

BİLİMSEL YAYINLAR

“NON ALCOHOLIC HEPATOSTEATOZ AND NUTRITION TREATMENT” SEMTEMBER2016;20(3):296-305. GUNGOR H.,TURKER PF.  HTTP://WWW.GUNCEL.TGV.ORG.TR/JOURNAL/67/PDF/100483.PDF

 
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METABOLIC SURGERY

Metabolic Surgery | What is Metabolic Surgery?

What is metabolic surgery and how is it applied?

Metabolic surgery is the surgical treatment of metabolic syndrome, ie excess weight or fat in the umbilical region, and accompanying disorders.

Metabolic surgery literally means that any metabolic disease can be treated by surgery, but in daily practice, when we say metabolic surgery, it is important to understand that in adults, diabetes is treated by surgery.

After successful obesity surgery results not only limited to weight loss, but also concomitant diseases (diabetes, hypertension, liver fattening, etc.) has improved the concept of Metabolic Surgery came to the agenda. It is popularly known as şeker disease surgery and diabetes surgery.

The concept of metabolic surgery has emerged with the concept of obesity surgery. Because obesity surgery itself is a metabolic surgery, diabetes surgery at the same time.

Because, whether we do sleeve gastrectomy or gastric bypass surgery in our patients, high rate of diabetes in these patients, regression in blood pressure, regression in liver fat is seen.

The concept of metabolic surgery also includes the concept of obesity surgery.

However, in recent years, scientific studies especially in the first group of obesity with a body mass index of 30 – 35 kg / square meters, especially in patients with severe diabetes, especially in the concept of metabolic surgery, so the concept of diabetes surgery has brought to the agenda.

In this patient group, if there is diabetes and in the first group of obesity, metabolic surgery can be performed very easily and this patient group can get rid of concomitant diseases.

What is Metabolic Surgery? Who can it be applied to?

Metabolic surgery is gaining attention in recent days as a frequently heard method. Weight increase, diabetes, cholesterol and high blood pressure with the name of the table is called Metabolic Syndrome. Metabolic surgery is to treat patients with type 2 diabetes using surgical methods.

Metabolic surgery, obesity and obesity surgery treatment, diabetes and surgical treatment of diabetes Metabolic Surgery Specialist Doctor Op.Dr.Ersoy Taşpınar performs metabolic surgery operations for Type 2 diabetes patients.

Metabolic Surgery Bursa Specialist at Metabolic Surgery, in Bursa Metabolic Surgery Center Op.Dr. Ersoy Taspinar is in service for the procedures of obesity surgery and treatment of obesity, diabetes, and also he gives information about the surgical treatment of obesity and diabetes Bursa Turkey serves Diabetes Surgery Center.

If Drug Treatment Is Not Enough … Metabolic Surgery.

Metabolic surgery is applied to patients who have tried medication but failed to improve.

Many disorders such as neuropathy problems, retinopathy, hypertension, gout, liver fattening, high triglycerides enter the life of the person with diabetes.

At this stage, appropriate patients can undergo metabolic surgery, who are approved by the doctor.

 

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DUODENAL SWITCH

Duedonal Switch - What is Duedonal Switch?

The surgical method known as switch or duodenal switch is a surgical operation that combines both sleeve gastrectomy and gastric bypass characteristics.

The process is performed in two steps. First, a sleeve gastrectomy is performed in which approximately 80% of the stomach is removed and the rest is formed into a thin tube.

As a result, the stomach with a volume of 1.5-2 L takes the form of a thin and long tube with a volume of about 120 ml. This part of the surgery is an irreversible surgical procedure.

The small intestine (duodenum), which is normally attached to the stomach, is then separated to form a bypass and two separate pathways and a common canal are formed.

The consumed food is normally directed from the tube-shaped stomach after sleeve gastrectomy to the beginning of the small intestine, but is directed to the lower part of the small intestine and from there to the colon.

This sleeve is the short portion of the small intestine that is separated after gastrectomy.

The other path of the longer part of the small intestine is the part where bile and other digestive enzymes mix with food and lead to absorption, the length of which is reduced to 250 cm. As a result, because the stomach volume is too small, the patient gets a sense of satiety by eating less and because the nutrients are absorbed less as the pathways of the small intestine are reduced, the amount of calories left in the body becomes less.

This method, which is generally used in diabetic patients with a high body mass index, can be performed in a single operation, but it can be applied gradually. In the first stage, a different operation can be performed for bypass 6-18 months after sleeve gastrectomy.

With this method, patients can lose 70-100% of their excess weight.

What is Duedonal Switch?

At the exit of the stomach is a muscle system called pylorus. The pylor has the function of a valve which allows the food contained in the stomach to be controlled to pass into the duodenum, ie the duodenum.

The pyloric muscle also prevents ingestion of the digestive fluids from the bile duct and pancreatic duct opening into the duodenum.

In biliopancreatic diversion (BPD) surgery, pyloric muscle is taken along with the last part of the stomach.

Due to the absence of pyloric muscle, dumping syndrome is frequently seen and severe.

In addition, ulcer development in anastomosis is more common in the absence of pyloric muscle.

Duodenal Switch is another type of Biliopancreatic Diversion (BPD) operation where the stomach is reduced to protect the pyloric muscle and the small intestine is connected to the duodenum two cm. after the stomach and pylorus.

These two are called Biliopancreatic Diversion-Duodenal Switch (BPD / DS).

Why choose Duodenal Switch?

Statistically it is the most comprehensive weight loss method in surgical interventions.

Optimal method for diabetes, high blood pressure, high cholesterol and high triglyceride. The most effective solution for high-calorie-fed patients.

Does not cause indigestion because the “pyrolic valve in of the stomach is preserved This method reduces appetite and the feeling of hunger because of the removal of the stomach that produces GHRELIN (starvation hormone).

This method causes more loss of weight compared to clap or Gastric Bypass methods.

The Duodenal Switch procedure (also known as vertical gastrectomy, biliopancreatic deception, DS and BPS-DS) limits the amount of food consumed (vertical gastrectomy reduces the size of the stomach) and reduces the amount of calories entering the body. (duodenal valve) Duodenal Switch surgery causes more weight loss than it directly affects metabolism and is a more effective method for the treatment of diabetes, hypertension and high cholesterol diseases.

Since it is an application that reduces fat absorption, it is a specially developed method for patients who eat fatty foods.

How is Duodenal Switch Surgery performed?

The first stage of the surgery is to remove 85% of the stomach, such as sleeve gastrectomy or tube stomach surgery, and turn the stomach into a thin tube.

This section has the effect of restricting food intake. In the second stage, the intestine is separated by a few cm ahead of the annular muscle layer called the pylor, and a little behind the spill of the bile-pancreatic fluid.

Gastric outlet from the small intestine-large intestine junction with the small intestine at a distance of 250 cm backward mouth.

That is, the length of the bowel, where bile and other digestive enzymes are mixed with food and leads to absorption, is reduced to 250 cm.

This procedure reduces the absorption of calories and fats in foods by a rate that is higher than that of gastric bypass.

Surgical Methods Used in Duodenal Switch Surgery:

1) Robotic Surgery (Robot Assisted Minimally Invasive Surgery):

2) Open Surgery:

Open duodenal switch surgery is performed through a large incision in the abdomen of the patient.

The size of the incision prolongs postoperative recovery time.

The biggest advantage of open surgery is that the surgeon performs the operation by feeling the tissues.

3) Laparoscopic Surgery (Minimally Invasive Surgery):

As in the robotic duodenal switch surgery, the operation is performed through small incisions in the abdomen of the patient. The surgeon at the patient’s head performs the operation with long, flat laparoscopic instruments accompanied by a 2-D image provided by a camera called a laparoscope.

 

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BARIATRIC (OBESITY) SURGERY

BARIATRIC (OBESITY) SURGERY

Bariatric Surgery Team of MEDICANA comprehends how important it is for you to decide an obesity surgery.

We are so decisive in to use our knowledge and act very carefully at all stages of the surgery and to help you with an ultimate attention in all issues that will change many aspects of your life.

Some of our team members had undergone obesity surgery and therefore, we know somewhat more details about the facts of life after the obesity surgery. Obesity surgery is the first part of a long process and it is also the key of success after the treatment. Our support is a part of your journey that will create a real difference for your target.

Bariatric Surgery Team of MEDICANA considered patient feedbacks, while post-slimming care program was planned and thus, we developed a patient-guided program. Our program will facilitate the changes in your life style and eating habits that you will be need to gain maximum benefit from your operation. We get menus planned by your dietician and meet our patients in Sunday breakfasts, hiking, outdoor sportive activities under guidance of our sportive consultants; we will always with our patients in seminars that address what you should consider while living you’re your new body after the operation. Our surgeon, dietician and psychologist will be available in all meetings and you will have the opportunity to ask any question in your mind. Patients who want to attend will a chance to meet the same team and other patients, who were operated on, in a WhatsApp Group.

If you think about undergoing obesity surgery and seek more information before scheduling an appointment, you should contact our obesity contact person.

Compliance to your diet plan to lose weight may be a stressful situation for you, your spouse or your family. Please call our obesity surgery team, if you face difficulty in coping with this stress. Moreover, you may talk with your family, friends or our psychologist.

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