Gastric sleeve surgery has become the most preferred surgery among obesity surgeries today.

In this surgery, the wide side of the stomach is released from the surrounding tissues by using sealing and cutting tools by entering the abdominal cavity through the openings of approximately 1 cm in the abdominal wall with the laparoscopic method. Then, 70-80% of the stomach is removed with special tools that we call surgical staplers, which perform both stapling and cutting. A small banana-shaped stomach remains. Due to this reduced portion, overeating is restricted. As most of the hunger hormone (ghreline) is secreted from the removed part of the stomach, the feeling of hunger decreases after the surgery and people feel full quickly. The rapid passage of food from the shrunken stomach to the small intestine also has an effect on rapid satiety.

Gastric sleeve surgery is getting increasingly common around the world, because it provides almost similar weight loss and long-term maintenance compared to other bariatric procedures although it is a simpler, shorter time and less risky surgery. Due to its short operation time and the lesser risks, it may be possible to perform sleeve gastrectomy in some patients for whom other surgeries are not considered appropriate. Another important feature of this surgery is that it can be converted to other bypass surgeries if needed. This feature can be used in two ways.

First of all, in severely obese patients, sleeve gastrectomy can be performed initially in order not to impose high risks of surgery on the patient, and after losing an appropriate amount of weight, it can be converted to bypass surgery. Secondly, it can be converted into bypass surgeries as revision surgery in patients who regain weight after gastric sleeve surgery . As a result, we recommend sleeve gastrectomy surgery as the first choice unless there is a contrary reason. Obesity causes many organic problems as well as social and psychological problems.

Obesity is a problem that affects not only the patient but also his/her environment.

Obesity should be considered as a health problem, but we cannot deny that it also causes cosmetic problems. Cosmetic effects may result in the psychosocial problems. Like as any disease, preventive measures are the best approach in obesity. Paying attention to diet and doing daily exercises will eliminate this problem before it occurs.

The fact that the body mass index is above normal should be a stimulus for us and we should take action at this stage. We need to shed our excess weight by paying attention to our diet and doing exercises. Let’s not forget that, as our weight accumulates, we will progress towards the class described as obese. And another thing we should not forget is that, as our weight increases, it will become increasingly difficult for us to lose it naturally, such as diet and exercise. Very few (less than 3%) of the patients with a body mass index over 40 can lose their weight with diet and exercise.

Obesity surgeries affect the anatomy or position of the stomach and small intestines. These changes cause many hormonal and metabolic changes as well as reduced eating capacity. Many of the hormonal signals are affected by these processes and it becomes easier to lose weight. Appetite decreases, satiety (feeling of fullness) occurs. It does not force the body to spend less calories by causing changes in metabolism. Despite all this, it should not be forgotten that bariatric surgeries are a means of weight loss and should be supported with a healthy diet and regular exercise.

Genetic factors, pregnancy, aging, drugs such as steroids and antidepressants, and some hormonal diseases are among the factors that cause obesity.

Obesity has been recognized as a disease by the World Health Organization. The degree of obesity is determined by calculating the body mass index. As the body mass index increases, the chance of getting rid of obesity decreases with conservative methods such as diet and exercise. It has been shown that only one percent of patients with an BMI above 35 return to normal weight with exercise. Therefore, obesity surgeries are the most effective way to reach and maintain normal weight in this group of patients. Weight loss surgery not only corrects obesity, but also treats obesity-related conditions such as diabetes, heart disease, high blood pressure, arthritis and reflux. Other important benefits of bariatric surgery are that it greatly reduces the risk of death from cancer, diabetes, heart disease and other diseases.

Almost all individuals who get bariatric surgery lose more than half of their excess weight.  After one and half or two years, some weight gain may be observed again, but very few patients return to their old weight. When compared to the patients who loose weight by bariatric surgery and those who loose by other methods, regaining the lost weight is much less in those who underwent surgery.  The important thing here is to maintain eating habits and exercise after surgery.

metabolic diseases; Type 2 DM, hypertension, lipid elevation in blood, Cardiovascular diseases,

Stroke,

Sleep apnea,

Gallstone,

Gout,

joint ailments

Some cancers such as breast, ovarian, endometrium, prostate, colon cancer

They are high-risk patients for the development of polycystic ovary syndrome, hypogonadism, and infertility.

Obesity is also a condition that causes many psychological problems such as depression and many social problems such as social exclusion.

Although obesity surgeries are thought to be a cosmetic surgery by many, large scientific studies on hundreds of thousands of patients have shown that these surgeries reduce the risk of death in obese patients by more than 40 percent.

If we examine these surgeries in terms of diseases, we see that deaths due to heart disease decreased by 40%, deaths due to diabetes by 92%, and deaths due to cancer by 60% after surgery. Of course, the risk of surgery comes to the fore, however, it is necessary to evaluate the benefits of the surgery together with the risks. Although the risk of surgery seems high, the risk of death due to bariatric surgery has been found to be almost the same as gallbladder surgery. Knowing the risks of the surgery along with the benefits will make it easier for us to decide on the surgery.

It has been shown that 90% of patients lose more than 50% of their excess weight after bariatric surgery and this situation can be maintained for many years.

When patients get rid of the vicious circle they have fallen into due to excess weight thanks to surgery, their life energy will increase, hormones will change, they will get rid of the social and psychological problems and pain they experience, and thus a sustainable weight loss will be achieved. A healthy diet and regular exercise habits are the biggest supporters of weight loss and weight balance after surgery.

Certain vitamin, mineral and protein deficiencies may occur after obesity surgeries, especially after bypass procedures in which intestinal absorption is impaired. Therefore, patients need protein, vitamin and mineral supplements. Problems that may occur if these deficiencies are not replaced:

Loss of bones and muscles

Anemia,

Tiredness,

Decreased night vision

Weakening of the immune system,

Decrease in senses such as touch, taste and smell,

Conditions such as deterioration in mental health may occur.

It can be easily prevented by regular follow-up and replacing the deficiencies.

We may need to stop medicines we use after obesity surgery, but may also need to start new ones, like vitamines. Since significant improvements are seen in many diseases, especially in diabetes and hypertension, after obesity surgeries we either reduce the doses of the medicines we use or stop them altogether. In other words, if we have obesity-related diseases, a re-evaluation should be made after surgery and our need for medication should be reconsidered.

The need for aesthetic surgery as a result of sagging after weight loss differs from person to person. The age, weight, distribution of fat in the body, body perception the person and the amount of sagging after weight loss are among the factors that determine the need for aesthetic surgery. Post-operative exercises may be beneficial in reducing this need.

Especially in the first months after the surgery, hair loss can be seen even if we take all the necessary vitamin, mineral protein support. The good thing is that these spills are temporary. As long as we continue our regular nutrition with vitamin, mineral protein support, improvement will be observed.

For desk jobs, a rest period of one to two weeks will suffice. For heavier work, 3-4 weeks of rest may be required depending on the intensity of the work.

Pregnancy is not recommended for one to one and a half years after bariatric surgery. It has been shown that the pregnancy and birth process after this period will be more comfortable than the period when the mother will live with high weight, and the babies will be healthier.

In those who lose weight, the possibility of miscarriage and stillbirth, the need for cesarean section and the risk of babies being affected by maternal obesity are also reduced.

It is not recommended to get pregnant within 1-1.5 years after bariatric surgery.

Particular attention should be paid to birth control after surgery. Because as women lose weight, their chances of getting pregnant increase much more than before. The effect of birth control pills during this transition period is also unreliable. For this reason, methods other than birth control pills such as intrauterine devices or condoms may be preferred for birth control.

Preoperative diet has great benefits, especially in extremely obese patients. With a 2-3 week diet, the patient’s liver can be reduced and intra-abdominal fat can be reduced, which makes the surgery more comfortable. It also helps the patient to get used to the new life order.

If you can manage to eat so little, of course, you will get rid of your excess weight. Obesity surgeries are recommended for those who cannot manage to eat so little.

To understand this in more detail, we need to know some topics. There are many hormones that maintain your body’s weight balance. These hormones create hunger or satiety to keep us at our current weight. A 50-pound person’s need to eat is not the same as a 100-pound person’s need to eat.

Whatever weight we are, our body accepts that weight as normal and determines the need for food according to that weight, and accordingly, it increases our appetite or creates a feeling of fullness. Of course, this is not something that turns on and off like lowering and lifting the electric switch. Sometimes we do not eat even though we have an appetite, or we eat extra even though we do not have an appetite. There are also external factors that increase or decrease our appetite. After all, if we manage to not eat too much and spend more energy than we take in, we lose weight.

Otherwise, it will be difficult for us to lose weight by continuing as a vicious circle. A shock effect is needed to break this vicious circle. This shock effect does not necessarily have to be surgical. If we can control ourselves with a strong will, we can achieve this. If we cannot achieve this, surgery stands before us as a strong alternative. The surgery makes it much easier to comply with the diet. Because with a stomach with a small volume, we cannot eat much, even if we want to. In addition, since we remove the fundus part of the stomach where appetite hormones are secreted, our appetite also decreases. Third, the food that passes from the small-volume stomach to the intestines quickly creates a feeling of satiety by affecting the hormones there. With all these effects, that is, with the support of a few arms behind us, it is much easier for us to lose weight. Also regular exercise after the surgery is recommended to achieve and keep targeted weight whole life.

You will be on a diet after the surgery, but you can do it much easier than the diets you did before the surgery. Two important factors that make it difficult for you to diet before the surgery disappear after the surgery. The first and most important of these is your appetite, and the second is your capacity to eat. The decrease in the stomach volume and your appetite after the surgery will help you a lot in correcting your eating habits, in other words, in your diet. you will be able to eat everything after the operation, but the amount will be very reduced and you will be satisfied with a small amount.

Exercise is important for many patients, not only for consuming calories, but also for stress and appetite control. Exercise is important for young people, but becomes even more important later on. Regular exercises are beneficial especially to protect the health of our muscle and bone structure. The recommended form of exercise is continuous and moderate, not overly demanding activities. Another important issue is that instead of forcing ourselves to exercise in a certain type and duration, we should organize an exercise plan suitable for ourselves.

We recommend starting sports as soon as possible after the surgery. We start our patients for short walks by getting them up 4-5 hours after the operation. We recommend that this should be increased over time. Here, you can walk as much as your body can tolerate and switch to other sports without too much effort. We recommend that you avoid lifting too much weight and overexerting yourself for the first month.

In order for humans and other living things to survive, they must be able to meet their basic needs. Hormones are needed in the body to keep them in balance.

Food and water intake, that is, the feeling of hunger and thirst, is managed by the part of the brain we call the hypothalamus. There are centers in the hypothalamus that both create the feeling of hunger and suppress the feeling of hunger. Some hormones create a feeling of hunger by stimulating this center, while another group creates a feeling of satiety. Especially in the small intestines, pancreas, and fat cells, many hormones are secreted that suppress appetite.

The hormone that we call ghrelin, which increases appetite, is mostly secreted in the convex upper part of the stomach. As it is known, this part is removed in sleeve gastrectomy surgeries. Patients who have undergone gastric sleeve surgery are able to eat less because their stomach volume is reduced, and their appetite also decreases due to the removal of the part that secretes appetite hormones. Thus, people who have this surgery can achieve success in the weight loss process with both their shrunken stomach and reduced appetite.

What is expected from an excellent treatment is that it is effective, has few risks and side effects. When an evaluation is made to consider this balance, we recommend gastric sleeve surgery due to both the effectiveness and the lack of surgical risks and metabolic problems that may occur after the operation. We recommend gastric bypass surgery for patients with reflux and suitable type 2 diabetes patients.

First of all, we need to know that;

Obesity surgeries are recommended for people who cannot get results with methods such as diet, exercise and drug therapy. Of course, we do not recommend surgery to every person who feels overweight.

Worldwide accepted criteria have been developed for recommending surgery.

1- The patient should not have any health problems that prevent obesity surgery.

2- The patient must be mentally competent to comply with the post-operative recommendations. Postoperative problems are experienced in patients with eating disorders and psychological problems.

3- There should be no problems such as alcohol and substance abuse.

4- It is necessary to have a body mass index over 35 or have a body mass index over 30 and have obesity-related health problems. Not recommended for patients who do not meet these criteria.