Bariatric Surgery Procedures

How do you know if you are a candidate or not for Sleeve Gastrectomy?

The decision for bariatric surgery is a serious one. The process should start with good planning.

You must have a BMI over 40 or over 35 and have an obesity-related disease.
((such as high blood pressure, diabetes 2, joint problem, liver / cholesterol disease)
Having obesity for a long time and no solutions. ( tried diet / medical traitement..)
You should not have an alcohol or drug addiction.
You must be between 18 and 65 years old. (However, younger or older people can be operated if their health conditions are suitable.) We even have 72 and 73-year-old patients.
Absence of cancer or pregnancy. Pregnancy should be planned for 18 months after surgery.
You must not have a psychiatric illness.
Having a good motivation for the procedure and understanding e.thing well.

After a multidisciplinary analysis of your health / eating & life habits, the most appropriate planning is made for you. (Restrictive or malabsorptive procedure.)
What can bariatric surgery help improve your life?

Weight loss surgery is the most effective method in the treatment of obesity and related diseases (There is improvement in related diseases such as DM, HTA, Sleep apne, Hiperkolesterolemi, Fatty Liver, Joint pain...)
To increase your quality of life and to extend your life.

How does sleeve gastrectomy (st.reduction surgery) work?

Reduces the desire to eat. (hormonal effect)
Reduces the feeling of hunger.(hormonal effect) LESS
Less food is eaten due to the reduction of stomach volume. (volumetric effect) Quick
Food passes quickly through the stomach.

How is the surgical procedure performed?

Laparoscopic surgery is a closed surgery. The procedure is performed with special cameras and instruments entered through small incisions in the abdominal wall.
The left side of the stomach is completely freed from vessels and organs.
The anesthesiologist inserts the gastric tube into the stomach.
After the new stomach volume is adjusted by the bariatric surgeon, 75-80 percent of the stomach is cut and removed with a special tool called a stapler.
The incision line of the stomach is sutured to reduce the risk of leakage and bleeding.
After the leak test and bleeding control, the sleeve gastrectomy procedure is terminated.
The patient can walk 4 hours after the operation. The next day, after the leak control is done, the liquid diet is started.

How much weight can be lost after sleeve gastrectomy?

On average, 80-85 percent of excess weight is lost.
You lose weight fast in the first 3 months.

In the first 3 months, approximately 40 percent of the excess weight is given.
In the first 6 months, approximately 60-65 percent of the excess weight is given.
In the first year, approximately 70-75 percent of the excess weight is given.

Real success happens if more than 85% of weight is lost.
This weight loss may continue for up to 18 months but is very slow after 1 year.
***In order to achieve the goal with full success, you should never forget diet, sports, psychological advice and doctor checks.

Which obesity-related health problems can be solved / improved ?

As many studies show, the following obesity-related health problems can improve.

Type 2 Diabetes Mellitus
Hipertension
Fatty liver diseaseSleep Apnea
Decreased risk of certain cancers.
Asthma / Migrain, Gout, Urinary incontinance
Joint Pain
İnfertility and sexual impotence.
Self insecurity and some psychological problems.

Recovery after Sleeve Gastrectomy Procedure

After the decision to have surgery, the average duration of preparation, surgery and hospitalization is 3-4 days.( 80% of the patients are discharged from the hospital on the 2nd day.)
For the procedure, you should stay in the city where the hospital is located for an average of 10-15 days. You can travel after the post-operative control examination.

Our patients are mobilized and walked 4 hours after the operation.
There is less pain and sensitivity as the surgery is performed with closed (laparoscopic) surgery.
The next day, our patients start a liquid diet.
Most of our patients can return to work after 10-15 days. Of course, we have patients who start work on the 5th day or who start after 1 month due to heavy work.
The first 15 days are the adaptation time of the body and our habits.
Liquid diet for the first 15 days, puree and soft food diet for the second 15 days, and a normal diet after 1 month.
In order to have good body functions, you must drink enough water.(Our patients do not feel very hungry after sleeve gastrectomy.)
The exercise program can begin 4 weeks after surgery. Psychological support should not be forgotten either.

What are the risks of the bariatric surgery procedure?

The risks of obesity (20%) are much higher than the risks of bariatric surgery (%02-3).
Today, sleeve gastrectomy has become a safe surgical method. Millions of people undergo bariatric surgery every year.
However, there are certain risks in every surgery and sleeve gastrectomy.
Risks can occur instantly, in the short term, in the medium term, or in the long term.

Anesthesia-related risks
Risks associated with surgery
Risks caused by the patient and his environment.
Excess skin may sag after weight loss. (Need esthetic surgery)
10 to 20% of patients may regain weight because of do not pay attention to their lifestyle and not care about their follow-up.

Such as: Leakage, bleeding, infection, clot, stenosis....
In order to minimize the risks:

The patient is well prepared,
Necessary precautions are taken & drugs (antibiotic / anticoagulant) are given.
Anti-embolism socks are worn.
Qualified team, special surgical instruments and materials are selected.

Diet & Follow up after bariatric Surgery (Sleeve Gasterctomy)

Day 1 Clear liquids: water / herbal tea etc.
Day 2 – 14 : Liquid diet program. Water, Clear soups (vegetable broth, chicken broth, broth..), fruit juices, ayran, milk, protein support liquids.
Day 15 – 30: Vegetable and fruit purees and soft foods. Nonfat yoğurt
After one month: Normal foods are started within the diet program. Nonfat and Low caloric diet.
You should eat small portions (5-6/ day. You have to chew your food 25-30 times.
Normally you don't need vitamins and minerals. However, minimal support can be given for a certain period of time for those with a history of deficiency. (vitB or İron)

Sleeve Gasterctomy vs Gastric Bypass

There is a difference in surgical technique.

In sleeve gastrectomy, only the stomach is reduced
In gastric bypass, the stomach is reduced and intestinal transit is changed.

The risks of surgery are different. Bypass risks are higher. Because there are 2 anastomosis in gastric bypass.
Mineral and vitamin support may be required in gastric bypass.
After gastric bypass, Intestinal obstruction, marginal ulcers, dumping syndrome, hernias can be seen.