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Metabolic Surgery

Metabolic surgery (Diabetes Surgery) should focus on functional limitation. The only way to do this is to activate the ileum-induced palatable neuropeptide hormones in the early stages of feeding. If the extremity satiety signals are too weak or too late, the person may be consuming too much food until metabolic satiety occurs.

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Diabetes surgery

Metabolic syndrome is a disease caused by central obesity that begins with insulin resistance, hypertension, elevated cholesterol and fasting sugars, and good cholesterol (HDL). There is a close relationship between type 2 diabetes and obesity; About 80% of obese people are obese in about 40% of people with diabetes and people with type 2 diabetes mellitus.

A person with at least 3 of the following criteria is considered to have metabolic syndrome.

– Waist circumference is > 102 cm for men and > 88 cm for women

– Triglyceride level is at or above 150 mg/dL

– LDL cholesterol is less than 40 mg/dl in men and 50 mg/dl in women

  • High blood pressure (>130/>85 mmHg)

  • High blood sugar (>110 mg/dL) 

What Are the Types of Surgery Performed With Metabolic Surgery?

It is a functioning mechanism based on the principle of using hormonal changes by a displacement operation (transposition/interposition) in metabolic surgery operations. In type 2 diabetic patients who do not have serious weight problems from metabolic surgery, it is possible to change this hormonal structure independently of weight loss and control blood sugar levels. Basically, metabolic surgery is weight loss surgery.  

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Transit bipartition

It is one of the methods used in patients with metabolic syndrome. It is a technique introduced to literature by Sergio Santoro. It is one of the methods used in type 2 diabetes and has a high success rate.

Metabolic and bariatric activity is in the foreground. With this method, 1/3 of the ingested food is passed through a 2/3 gastroenterostomy line and passes through all segments of the intestine through the normal anatomical route. In metabolic surgical procedures, part is based on removing the stomach and relocating the small intestine.

From a distance of 6 cm from the gastric exit part, the stomach is cut and sewn with special materials. Subsequently, gastroenterostomy is performed with a distal portion of the ileum of 250 cm. 

Ileal Interposition Surgery

It is the process of replacing the first part with the last part of the small intestine through intervention. This surgery disrupts the hormones that cause insulin resistance and regulates sugar levels by increasing hormone levels that increase insulin resistance.  

bypass type

DOUDENOJENJENAL BYPASS:

It is one of the methods used in patients with metabolic syndrome. DJB/SG is a metabolic surgical method that has long-term weight loss effect and good comfort of life. DJB/SG is a surgical technique performed with partial resection of the stomach, bulbar resection, and bulbo enterostomy anastomosis to bypass a specified length.

 

 

MINI STOMACH BYPASS

With weight loss achieved through standard bypasses, metabolic syndrome is also treated with this technique. In this technique, a tube is made from the entrance of the stomach. Also in the first part of the small intestine, first 200-250 cm, a loop gastroenterostomy is performed to connect the tube and the small intestine. By shrinking the stomach, reducing absorption and decreasing the production of ghrelin in the inactive part of the stomach, the patient loses weight. 

JEJENOILEAL BYPASS

One of the bariatric surgery methods that cause absorption disorders. A method that limits weight gain for a long time. It is recommended to apply in specific cases due to malabsorption.

ROUX-EN-Y STOMACH BYPASS

It is an operation that reduces the amount of food the patient receives and limits the intake. In this operation, a small gastric pouch with a volume of 30-50 ml is created in the stomach. Approximately 80 cm of the starting portion of the small intestine is resected and the gastroenterostomy is performed with the distal end and the proximal enteral end anastomosed to enteral which is 120 cm in.

INTRAGASTRIC BALLOON APPLICATION

The intragastric balloon is placed in the stomach and the balloon is inflated. This procedure makes the patient feel full and reduces food intake. The intragastric balloon is removed after approximately 6-12 months.  

What is the difference between sleeve gastrectomy and metabolic surgery?

Sleeve gastrectomy is a bariatric surgical method used in overweight patients without metabolic syndromes. High blood sugar and blood pressure can be examples of metabolic syndrome. Metabolic surgery is performed to cure these metabolic syndromes. Even if the patient is overweight, bariatric surgery can be combined with metabolic surgery.  

How is the preparation for pre-metabolic surgery?

All patients who will undergo metabolic surgery are first subjected to very extensive tests, blood tests, ultrasound of the whole abdomen and gastroscopy.  

After the examinations and examinations are completed, the obesity surgeon evaluates the patients and their results. If the patient is unable to undergo obesity surgery, it will be decided which obesity surgery will be performed. 

Postoperative period

Under normal circumstances, you will be admitted to hospital 1 day before surgery. You will be given medicine to treat your blood sugar and hypertension. You must follow a liquid diet 1 day before the operation and do not eat anything after midnight. If everything is normal during the postoperative period, you will have 3-4 days of hospitalization.

  • The liquid drink is taken from the mouth.

  • Detailed information on nutrition and daily activities after discharge will be provided orally and in writing. 

If you have additional questions, please feel free to contact Mehtab, 

Regards Mehtab,

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