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What surgical methods can be used in the treatment of morbid obesity?
Morbid obesity treatment is performed by laparoscopic (closed surgery method) method. The surgical methods used in the treatment of morbid obesity can be divided into two main groups:
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Restrictive (limiting, minimizing) methods
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Malabsorptive (absorption disruptive) methods
The principle of action of restrictive methods is to reduce the amount of food intake by reducing the stomach volume and to reduce the level of the hunger hormone (ghrelin) secreted from the stomach by removing tissue from the stomach. The most commonly used of these methods is sleeve gastrectomy.
Malabsorptive methods, on the other hand, reduce the amount of energy entering the body by impairing the absorption of food, as well as allowing food to reach the advanced parts of the intestine faster in order to increase the hormones (Peptide YY, GLP) that trigger fat burning. Examples of these methods are Roux en Y gastric bypass, mini gastric bypass, biliopancreatic diversion-duodenal switch, transit bipartition, ileal interposition, duodenojejunal bypass. Among these, Roux en Y gastric bypass and mini gastric bypass are the most commonly used methods.
Gastric sleeve surgery (Sleeve gastrectomy): It is currently the most commonly used method. It is a restrictive surgical procedure. By reducing the stomach volume, it reduces food intake and secretes the hunger hormone ghrelin. It is the process of removing a part of the stomach and turning it into a tube-tube with a diameter of approximately 1.5 – 2 cm, like the esophagus and the next duodenum. Since the anatomy of the gastrointestinal tract is slightly impaired, conditions such as diarrhea, fluid loss, and vitamin deficiency are less common afterwards. It is most preferred in patients with a large amount of eating.
Roux en Y gastric bypass:It is both restrictive and malabsorptive surgery. A small (approximately 40-50 ml) pocket is prepared by dividing the remaining stomach in the initial part of the stomach. The small intestine, which is approximately 1 m from the beginning, is mouthed into this stomach pocket, and energy intake is reduced by restricting food absorption in the intestine of approximately 2 m in length. This surgery is more recommended in patients with predominant consumption of sugar and sweets. Afterwards, diarrhea, fluid loss and vitamin deficiencies can be seen at the beginning, for these it is absolutely necessary to use supportive treatment. Dumping syndrome, which is seen after sugar intake after surgery and manifests as sweating, bad feeling, and fainting, is seen in patients. Therefore, these patients do not prefer to use sugar after surgery.
Mini gastric bypass:Roux en Y is a variant of gastric bypass. _cc781905-bbcde-3194 It has a sewing line. Its features and subsequent problems are similar to Roux en Y gastric bypass.
Transit bipartition:It is a method that has increased in popularity recently. It is claimed to be particularly successful in the treatment of diabetes. Long-term results are not yet clear.
Gastric balloon application:It is aimed to reduce the stomach volume and to lose weight by placing a balloon in the stomach by a technique called endoscopy, which is entered through the mouth with a tube with a camera at the end and reaches the stomach. The success of achieving permanent weight loss is lower than other methods. Since it does not require surgery, it is used to provide weight loss in obese patients who are at risk of receiving general anesthesia due to co-morbidities, and in patients with a weight of 200 - 250 kg, called super obese, with the aim of making the operation process more comfortable by providing some weight loss until the actual surgery. It is not preferred as a stand-alone weight loss method.
Ileal interposition, BPD-Duodenal switch, Jejunoileal bypass, SADI-SOther methods such as
Gastric band, gastric band, gastric bandThe method known as