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What is Gastric Sleeve Surgery | Obesity Treatments Cost?
Plastic Surgery Wednesday 23rd of March 2022

What you need to know about Sleeve Gastrectomy? What is Obesity?

Obesity is one of the biggest health problems of today. In general, obesity occurs when the ratio of body fat mass to lean mass increases by 20% and accumulates in the body. Body mass index measurement is used when calculating obesity. When this measurement is divided by the square of the person's total weight, the result shows the stage of obesity. According to this; If the body mass is over 30, it is obese, if it is over 40, it is morbidly obese, and if it is over 50, it is super obese.

Obesity is one of today's diseases that emerged as a result of the age of technology, that is, the life of industrial culture. Malnutrition (frozen fat, high sugar, carbohydrates and sweeteners, etc.) is shown as the most basic reason. Constant consumption of ready-made and unhealthy (fast food) foods due to intense work tempo, and fast-food foods that are difficult to absorb and digest as a result of not burning these foods cause intense weight gain in the short term. When we look at the statistical data, the fact that the places where obesity increases are big industrial cities or metropolises brings us the problem of work pressure and limited time again. The fact that the places where this disease recurs are not rural areas also shows that the living standards are lower in cities.

Obesity, which indirectly opens the door to many diseases, leads to diabetes (diabetes) disease the fastest. Diabetes and obesity are diseases that are directly related to each other, deadly and difficult to treat. For a healthy and well-functioning metabolism, people need to maintain a regular eating principle with a focus on vegetables and fruits, and lead an active life. People with the opposite lifestyle will eventually and in the short term face obesity and then diabetes.

Obesity combined with diabetes gains momentum in the weight gain process and continues to accumulate more and faster fat. The cessation of insulin production, the absence of a feeling of satiety, means that people constantly feel hungry, eat constantly and gain weight. It is becoming more and more difficult to lose weight, people's weight increases and they lose their mobility (morbidly obese - super obese), which brings psychological problems. After this depression, people who are under heavy stress are isolated from society, acquire an asocial life and completely lose their self-esteem, which brings with it more eating and weight gain. Although obesity treatment is always available, the majority of patients did not find this treatment reliable and accepted their condition as it was, since it involved a period of time that required intense patience. Various gastric and pancreatic surgeries developed in recent years have made the treatment of this disease easier.

Insulin Resistance – Type 2 Diabetes

The hormone insulin secreted by the pancreas ensures that foods are digested and carbohydrates are broken down into small pieces and given to the blood as sugar. Glucose, a type of blood sugar, is taken from carbohydrates with the hormone insulin and used for energy in the blood. Another function of insulin is to store sugar in many organs such as the liver and muscle, and to use it in times of hunger or stress, in cases where blood sugar is too high. Thus , the metabolic system functions in a healthy way, the body digests every food consumed and meets its energy needs, that is, insulin is an extremely important hormone for a healthy metabolism.

Insulin resistance occurs as a result of wrong and unhealthy diet (especially heavy sugar consumption), stress and various reasons. The pancreas stops the secretion of insulin, the sugar in the blood does not turn into energy and takes a very high place. This, in turn, quickly causes various disorders such as Type 2 diabetes, metabolic syndrome, foot and leg ulcers, and sleep problems.

What are the symptoms of insulin resistance?

  • Darkening of the skin
  • Skin softening
  • Gaining weight very quickly and having difficulty losing weight
  • Weakness, nervousness, and difficulty concentrating after meals
  • feeling faint
  • Consuming food fast, getting hungry fast
  • Sweet cravings
  • Tremors in hands and feet
  • Cold sweats and chills, decreased sleep quality
  • Irregularity in menstrual periods

It causes such symptoms. When type 2 diabetes occurs, patients begin to use insulin injections and various drugs at regular intervals under the control of a doctor. Permanent solutions to obesity and diabetes have been found with the developed gastric surgeries . This treatment process is very troublesome, especially for people who are struggling with diabetes due to obesity , and it requires patients to be patient and persevering.

Diabetes is a disease that can be treated with a healthy diet, active and sportive life, and avoidance of stress. Patients feel reluctance towards regular sports and diet due to reasons such as the feeling of constant or sudden fatigue, loss of energy and hunger, which are among the symptoms.

Insulin Resistance – Type 2 Diabetes

Gastric Bypass (Gastric Bypass)

Gastric bypass is a method that has been used in the treatment of morbid and super obesity for an average of 20 years. The purpose of this method is to speed up weight loss by regulating blood sugar by reducing the mixture of carbohydrates and fatty foods, which are foods that accelerate obesity, into the blood and intestines.

This surgery takes place as follows, in the first stage, 90% of the stomach is canceled and the other 10% is left approximately the size of a cup. In the second stage, the activated small stomach is 130 to 150 cm of the small intestine. It is tied in the future so that the surgery is completed. The aim here is to reduce the absorption of nutrients and accelerate the weight loss process by deactivating the part of the intestine where sugar and fat are absorbed the most.

After gastric bypass, the consumed foods go to the stomach, which is left in the size of a cup, a feeling of absence occurs immediately because the stomach is very small, then the foods that reach the intestine quickly, especially fat, sugar, carbohydrates are not absorbed, so they are easily thrown out.

The success of this surgery also depends on the patient's following the meals without interruption and not making any evasion between meals. Although the designed stomach is very small, the operation will be inconclusive if the patient does not pay attention to the diet program.

All of the surgeries performed in the treatment of obesity are called 'Bariatric Surgery'. The most effective method in the treatment of morbid obesity is gastric bypass, but it is seen as the last option as it is an irreversible method. Weight loss after gastric bypass is certain, patients lose 85% of their weight at the end of the first year, and at the end of the second year, patients reach their ideal and healthy weight.

Negative Effects of Gastric Bypass

The most important side effect of gastric bypass is a serious loss of appetite, as expected, due to the considerable shrinkage of the stomach. The nutrients taken are significantly reduced, which in turn reduces the intake of important vitamins and minerals such as protein and iron. This situation requires external supplementation of vitamins and this takes almost a lifetime. Even if the stomach, which shrinks and connects to the intestine by a shortcut, is perfect for weakening, it can also cause various side effects like this.

Other side effects:

  1. Bleeding: The most expected situation after almost every surgical operation is bleeding. This situation, which occurs at the point of the gastrointestinal connection, is sometimes experienced only at the entry points of the cannulas . Sometimes just morbid It can also be experienced as a result of vascular occlusion caused by obesity .
  2. is a condition that can occur after open surgery, depending on many reasons such as age, chronic diseases, degree of obesity , duration of the operation, opening of the intestines. Although this situation carries a very low risk in laparoscopic (closed) surgeries, it may require antibiotic treatment or reoperation if it occurs.
  3. Intravascular clot problem: Morbid Bleeding-coagulation problems were reported in 6%-18% of patients after obese surgery. A clot that may develop in the leg vein, which is one of the most critical points, may break off from the vessel and reach important organs such as the brain and lungs, causing congestion in the vessels here.
  4. Suture staple line leak – Anastomotic leak: If the gastrointestinal line, which is connected to each other with staples or sutures, remains open during gastric bypass, leakage from the intestine or stomach into the abdominal cavity occurs through these tiny holes. This condition, which has a 2 to 4% risk, causes an abscess or infection. This risk share, depending on the age of the patient, may occur at a higher rate in super obese and diabetic patients with a BMI higher than 50. Leakage complication is controlled with antibiotic therapy, interventional radiological drainage, and additional surgical intervention if it is advanced.
  5. Stitched staple line strictures: As a result of connecting the stomach and intestines with staples, this line heals by shrinking as in every wound healing. However, if this shrinkage occurs at an advanced level, this transition line may be narrowed. In case of excessive narrowing of the line, this area is entered with the endoscopic method and this area is enlarged with the dilation balloon method. This process can be repeated several times.
  6. What is dumping syndrome? It is a condition seen in 70% to 75% of patients after gastric bypass surgery. As a result of the food being thrown out of the intestines as it reaches the stomach, the person starts to lose weight rapidly. In addition, it causes problems such as cramps, nausea, diarrhea, fainting, swelling in the face and neck, palpitations, which are seen as a result of foods such as carbohydrates and simple sugar. Dumping syndrome, which is a very serious metabolic syndrome disease, can cause osteoporosis or anorexia if it progresses.

Ways to Avoid Dumping Syndrome:

  • Eating little and often
  • Limiting fluid intake before solid foods
  • Avoiding foods like carbohydrates and simple sugars
  • Consuming fiber-based foods
  • Prioritizing protein intake and adjusting our diet accordingly

7. Intestinal obstruction: Due to the decrease in the intake of nutrients, intestinal obstructions may occur after gastric bypass. This condition, which is observed in 1% to 6%, is an easily circumvented complication.

Patients should be very careful about their nutrition and patiently follow the doctor's instructions.

Stomach Balloon

STOMACH BALLOON

Obesity, which has become one of the most serious health problems of today, is treated with various surgical operations and needs long-term treatments. Tube stomach, which is a kind of slimming method, is the most risk-free and simple among obesity treatment methods. With endoscopy, a balloon is placed in the stomach and this balloon is inflated with water and kept in the stomach. With the balloon waiting in the stomach inflated, the patients feel a constant feeling of fullness, they eat less and finally they reach their ideal weight in healthy ways.

Super obese people need to lose a certain amount of weight for its application. A body mass index of 27 or higher, and not more than 18 years old and not older than 70 years. Gastric balloon, which is a very simple and much safer method compared to other stomach operations, is also preferred by people who do not want to undergo a surgical operation. With the balloon waiting in the stomach for 6 months, patients lose up to 25 kilos within 6 months to 1 year.

There are 4 types of gastric balloons, respectively;

  • 6 month old
  • 12 months
  • Ellipse can be swallowed
  • Adjustable

The balloon is lowered into the stomach by endoscopy, which is an illuminated camera, and sedation, which is a kind of anesthesia, is applied to the patient during this operation. In this way, the patient does not feel any pain or ache, and does not remember the operation. Before placing the balloon, the doctor observes whether there is any problem in the stomach, and places the balloon if no obstruction is observed. The operation takes 15-20 minutes on average.

Gastric Sleeve

At the point reached with the developing medical technology, obesity treatment has found much safer and healthier methods. Various gastric surgeries are available today, but most have considerable complications. Among them, the safest type is gastric surgery.

With this method, the stomach is formed into a thin long tube, similar to a banana. With this surgery, which is performed with closed methods (laparoscopic), a part of the stomach is cut and removed. In this way, patients with reduced food intake feel less hungry and lose weight quickly. The deficiency of important vitamins, which is an important problem in gastric bypass, which occurs with the decrease in food intake, may also occur after gastric sleeve, but this situation remains at a minor level.

Type stomach surgery takes approximately 1.5 hours. Since the entrance and exit of the stomach are not affected and no changes are made in the intestine, the continuity in the digestive system continues in a healthy way. If patients gain weight again after gastric sleeve surgery, gastric surgery is performed. Gastric stomach surgery, which is always preferred as the last option, is applied as a last resort in cases where type 2 diabetes is in the last stage and the body mass index is very high.

Who is Type Stomach Suitable for?

  • Morbid in the most advanced level of obesity such as obese, super obese (BMI over 40)
  • In case of serious diseases such as type 2 diabetes, sleep apnea, hypertension with a body mass index of 35-40

It is a preferred surgery. Stomach surgeries are not aesthetic surgeries, they are applied to save the lives of patients and to treat other diseases that develop accordingly.

The most important development after gastric sleeve surgery is the breaking of insulin resistance. Patients lose a significant amount of weight in the short term, of course, it is very important for patients to exercise regularly, follow the diet program carefully and make them a lifestyle. Because after losing weight, patients start to consume unhealthy foods again and return to a passive lifestyle, they will quickly return to their old weight. Which is quite common.

Usually awaits patients after all obesity treatments is sagging skin that occurs after weight loss. In areas such as arms, legs, abdomen and neck, the skin that loses its elasticity due to excessive weight droops by being severely eroded. When patients reach their ideal weight, the process waiting for them will be plastic surgery. In this sense, obesity treatment is a very complicated process that requires patience, perseverance and willpower. If you are persistent and faithful, everyone will reach their ideal weight, health and achieve physical satisfaction.

Gastric surgery Costs

As with all surgical operations, it is a very wrong behavior to explain a price for stomach surgeries. Patients should have one-on-one meetings with doctors, be examined, and other diseases caused by obesity should be considered. At the end of this whole process, the price will be determined by the specialist doctor and the patient will be informed. Which is again the most correct and healthy.