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.
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.
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.