Obesity and Metabolic Surgery

Obesity surgery consists of several surgical techniques to treat overweight. These operations principally make some modifications in the digestive system. Today, all of them are laparoscopically performed, i.e. closed methods.

The most important cause of obesity is excessive food consumption, leading to excessive calorie intake. If significant amount of fat accumulates in the body, the metabolism is totally disturbed and the satiety level gradually increases.

In the obesity surgery, basically two operations are performed. One of them is to reduce the gastric volume. If you decrease the capacity of stomach from 1 to 1.5 liters to 100 ml, the patient feels full even with very small quantities of food. This feeling of satiety is the superiority of obesity surgery over other methods. Because, all other methods recommended to the patient whether called diet or healthy nutrition, are condemned to fail due to the feeling of hunger and insatiate.

The other operation performed in our hospital is to shorten the length of the intestine, where the food is digested, by creating a new passage between the stomach and the small intestine. In this operation, no bowel is resected; just the food absorption is reduced by tying 1.5 to 2 meters of the small intestines.

The most common operation in the first group is laparoscopic sleeve gastrectomy. It is widely known as “tube stomach”. In this operation, no apparatus or tube is placed into the stomach. A large part of the stomach (85%) is excised. Since the remaining stomach resembles a thin tube, the operation is called as tube stomach.

The most common operation in the other group (i.e. reduced absorption group) is gastric bypass. In this surgery, the stomach is reduced. The small stomach pouch is attached to the distal end of the small intestine. The aim is to eliminate absorption of a part of fat and caloric content of foods.

This group is the most potent modality in obesity-related metabolic diseases including diabetes, hypertension and hypercholesterolemia. Without waiting weight loss as in others, blood sugar levels are restored to normal ranges, blood pressure is regulated and blood lipids decrease to physiological ranges. We frequently observe that our patients with blood glucose readings about 450 mg/dl, diabetic foot and  renal problems discontinue insulin and antihypertensive agents following the surgery.

Today, all these surgeries can be performed with only 4 to 5 small incisions (the largest one measuring 1 cm), without opening the abdomen thanks to the technological developments. Thus, the post-operative comfort of the patients has improved drastically. Therefore, our patients may engage in daily activities mostly within 5-7 days.