With Sleeve Gastrectomyy we are bringing the stomach to the shape of a tube. Thus, the volume of the stomach is reduced. More importantly, the secretion of the hunger hormone, ghrelin, is prevented. A part of the stomach parallel to its long axis is removed, and the stomach is brought to the tube’s shape, so that the person feels satiated with little food. The release of ghrelin, which is the hunger hormone and which encourages the person to eat if it is released, has been observed to decrease after tube stomach surgery. Surgeries on transforming the stomach into a tube are performed at a gradually increasing frequency all over the world before gastric bypass surgery.
Intra-abdominal Balloon Placement
A special balloon is placed inside the stomach, and it is ensured that the volume in the stomach is covered and the person feels that his stomach is full by giving up to 450-750 ml of serum or air inside it. It is appropriate to receive psychological behavior treatment and to support it with diet. Its effectiveness in weight loss is controversial. With this practice, 33% of patients lose a significant part of their excess weight. However, in the long term, such as 5 years, only 23% of patients lose 20% of their excess weight.
A round band (staple) is placed in the lower part of the stomach just below the junction of the stomach with the esophagus. The eaten foods stretch this part earlier, and as a result of this, the feeling of satiety is formed. Because of the applied staple, the amount of the solid food taken is limited since the stomach volume is reduced. However, in such an application, if the patient continues to consume liquid food, especially high-calorie liquid food, weight loss may not reach the desired level. The expected weight loss in the laparoscopic adjustable gastric bands placed with a closed system is between 50% and 60% of the excess weight within 1-2 years. Entering (migration) of the staple into the stomach and gastric perforation are undesirable conditions.
The aim here is both to reduce the volume of the stomach and to reduce the absorption surface of the intestines. Since it is based on the reduction of absorption, it may prevent the absorption of the substances that should be taken for the body from outside, and deficiencies of these substances may occur in the patient over time.
This application is also a procedure for reducing the stomach volume and the intestinal absorption surface. The greatest problem is the return of bile and pancreatic secretion to the stomach. The expected weight loss is 50% of the excess weight.
This application is also a procedure for reducing the stomach volume and the intestinal absorption surface.
What Is Obesity?
It is a disorder that can be observed with the increase in the amount of fat storage and energy in the body at the level that poses a serious risk to life and as a result with the inevitable increase in mortality rates.
Nowadays, the definition of obesity is based on the measurement performed according to the Body Mass Index. The BMI is calculated by dividing the body weight by height in meters squared. Accordingly:
|Normal range||18.50 – 24.99||18.50 – 22.99|
|23.00 – 24.99|
|Pre-obese||25.00 – 29.99||25.00 – 27.49|
|27.50 – 29.99|
|Obese class 1||30.00 – 34.99||30.00 – 32.49|
|32.50 – 34.99|
|Obese class 2||35.00 – 39.99||35.00 – 37.49|
|37.50 – 39.99|
|Obese class 3||≥40.00||≥40.00|
- Tip 2 Diabetes Mellitus (diabetes), Hyperinsulinemia, Hypertension, Insulin resistance, Hyperlipidemia – Coronary artery disease, Gallbladder diseases, Hypertriglyceridemia, Metabolic syndrome
- Sleep apnea, Cancer (colon and prostate cancer in men; gallbladder, endometrium, ovarian and breast cancer in women)
- Osteoarthritis, Paralysis, Fatty liver, Asthma, Difficulty in breathing, Increased surgical risks, Pregnancy complications, Menstrual irregularities, Excessive hair growth,
- Psychological (Anorexia nervosa-(starvation) or Bulimia nervosa (not benefiting from the eaten foods by vomiting), night eating syndrome or relaxation by eating something more, Binge Eating syndrome
In obesity, more energy is taken than consumed. Energy intake should be as follows: Energy intake = basal metabolism + energy required for physical activity. The energy taken above this rate causes genetic changes in each component. Still unknown genetic and known environmental factors that affect all of these play a different role in the emergence of obesity. Although the importance of different genetic structures is known, the increase in the frequency of obesity is explained by behavioral and environmental changes which are the result of technological developments (Shah, Rahaman, Hurley, Posch. 2006; 119: 61-74). If obesity is diagnosed, the next step is to exclude the causes of obesity. If the underlying source cannot be found in a large part, it is defined as “simple obesity=primary obesity=external obesity.” When genetic endocrine and other causes play a role, it is referred to as “secondary obesity=internal obesity.”