Daily Lifestyle Is The Most Important Factor in Preventing Obesity
Daily Lifestyle Is The Most Important Factor in Preventing Obesity
2022-05-20 12:41:46/ Kategori : General Surgery, Nutrition and Diet
What is obesity?
Obesity is excessive accumulation of fat in the body. This ratio is different for men and women. If excessive fat accumulation in the body impairs health, the condition becomes obesity. If this rate exceeds 32% in women and 25% in men, this accumulation of fat in the body is called obesity.
How to fight obesity?
One of the most important treatment methods in the fight against obesity is prevention. Behaviors and eating patterns are situations that need to be corrected within social behaviors. For example, it is important to add plenty of fresh fruits and vegetables to our daily foods, to increase exercise frequency and to treat it as a lifestyle. In general health policies, conditions such as cancer prevention are also valid for obesity. Daily lifestyles are the most important factor in preventing obesity for people.
Are you a candidate?
Selecting patients who are suitable for bariatric surgery is as important as performing the appropriate surgery. The most important factor here is to be able to adjust who will be the patients who are suitable for surgery. Along with the decisions taken by the American Society of Obesity Surgeons, the world bariatric surgery associations also make parallel decisions. Body mass index over 30; If other methods have been tried but obesity has not been treated, those who have other comorbidities such as diabetes, hypertension, and cardiovascular disease are included in the category of patients suitable for bariatric surgery. If the person’s body mass index is over 40, he is a suitable patient for bariatric surgery, even if he does not have any additional disease.
Body mass index (BMI) is calculated by dividing body mass (kg) by the square of the height in meters.
What are the bariatric surgery treatment options?
- Tube Stomach – Sleeve Gastrectomy
- Gastric Bypass
- Duodenal Switch
Tube Stomach – Sleeve Gastrectomy
Gastric sleeve / sleeve gastrectomy surgery is the most frequently performed surgery in obesity surgery all over the world. Some of the other obesity surgeries are at least as effective as sleeve gastrectomy. There are several reasons why obesity surgeons are increasingly recommending sleeve gastrectomy. At the beginning of these;
It is seen that the complications related to the surgery are less in sleeve gastrectomy compared to other types of surgery.
In addition to this comes the risk/benefit ratio assessment. While similar and desired results are obtained in weight loss and metabolic improvements with sleeve gastrectomy, which are more complex, long-term and ultimately require closer follow-up, less frequent follow-up and less vitamin and trace element deficiencies occur.
On the other hand, the operation is performed laparoscopically and with the developing technical processes, near-perfect results are obtained. This surgery, which is so widely performed in the treatment of obesity, shines not only with the emphasis of obesity surgeons, but also with the satisfaction of patients who have had sleeve gastrectomy surgery.
How is sleeve gastrectomy surgery performed?
Standard sleeve gastrectomy surgery is performed laparoscopically.
5 or 6 small holes are made in the abdominal wall.
The necessary space for the surgery is created by injecting carbon dioxide gas into the abdomen.
A special tube is placed in the stomach in order to form the tube stomach to the desired size.
At the borders of this tube, the stomach is formed into a tube with disposable instruments called staplers.
Stapler stitches and cuts at the same time.
Approximately 80-85% of the stomach is removed.
The remaining stomach volume is 100 – 150 ml. This amount is about a teaspoon.
A leak test is performed at the end of the operation. A dyed substance is injected into the stomach and it is investigated whether there is leakage from the operation areas.
The separated stomach part is taken out through a hole used at the entrance in the abdominal wall.
For safer results, another layer of suture is placed on the suture line and/or a special adhesive (fibrin glue) is applied.
Finally, a thin-silicone drain is placed in the operative field.
The duration of the operation is 60-90 minutes.
Gastric Bypass
Laparoscopic Gastric Bypass surgery has proven itself in obesity surgeries and its results have been studied extensively.
Until the last few years, it was by far the most applied method all over the world. The results of sleeve gastrectomy surgeries are comparable to gastric bypass, and sleeve gastrectomy operations can be performed in a shorter time and are used less frequently, as they cause fewer complications.
Gastric Bypass surgery is performed entirely by laparoscopic (closed) methods. As the biomechanics of obesity surgeries are understood, with the convenience of technology, developed smart devices and tools, near-perfect results are obtained. Laparoscopic Gastric Bypass surgeries can be positioned between sleeve gastrectomy (tube stomach) surgeries and duodenal switch surgeries when
considering their effectiveness and complications in obesity .
How is laparoscopic gastric bypass surgery performed?
Performing the standard gastric bypass surgery with the laparoscopic method is the gold standard. 5 or 6 millimeter-sized entrances are made to the abdominal wall. Straight tubes, which we call trocars, are placed here. The camera, work tools and staplers will be used by passing them through the trocars. The required working area is created by injecting carbon dioxide gas into the abdomen. First, a small pouch (pouch) is created in the stomach.
The stomach is close to the esophagus, about 30-50 ml. to be divided into two.
The volume of the pouch is 5% of the entire stomach volume. This volume
will reduce food intake in the person. No more food will pass through the remaining 95% of the stomach.
In the second stage, the small intestine is divided into two from the determined distance. The lower end of the intestine is brought up, that is, towards the stomach pouch, and the stomach pouch and the small intestine are combined.
In the third stage, the upper end of the small intestine is approximately 100 cm from the lower end of the small intestine combined with the stomach. combined at a distance. Thus, food is an important part of the stomach and about 100 cm of the small intestine. This process is called gastric bypass since they will be digested directly in the remaining intestine without undergoing the first part of the stomach. In other words, a shortcut was created for the digestion of food. The amount of food taken with the shrinking stomach is reduced. With the bypass, the absorption of food will decrease. At every stage of the operation, tools called staplers are used that can cut simultaneously while sewing on the one hand.
Finally, a thin silicone drain (tube) is placed in the required surgical area.
The total duration of the operation is an average of two hours. This period may be extended depending on the patient’s body mass index and previous surgeries.
Duodenal Switch
Duodenal switch surgery is the most effective method in bariatric surgery. It has an indisputable superiority when it comes to permanent weight loss, improvement of co-morbidities, and especially in the control of Type 2 diabetes. Although duodenal switch surgery shows such good results for obesity and the diseases it brings, its place among all obesity surgeries is below 1%.
There are certain restrictive reasons for choosing this surgery:
Early and late complications are more common after Duodenal Switch surgery compared to sleeve gastrectomy and gastric bypass surgery.
In the long term after surgery, the incidence of nutritional disorders and vitamin/trace element deficiencies is higher.
There are two indications for duodenal switch surgery in current bariatric surgery:
In patients with a higher BMI, over 50, and super obese
It is applied to patients who have previously undergone bariatric surgery but regained weight.
How is duodenal switch surgery performed?
Standard duodenal switch surgery is performed laparoscopically.
The necessary space for the surgery is created by injecting carbon dioxide gas into the abdomen.
The stomach is formed into a tube with disposable instruments called staplers.
The duodenum is cut close to the stomach exit.
The small intestine divides into two, 2.5 meters ahead of the junction with the large intestine. The lower end of the intestine is joined to the duodenum. This will be the new way of feeding.
The upper end of the separated intestine is combined with the small intestine, which is the alimentary tract.
Duodenal switch surgery is like combining sleeve gastrectomy and gastric bypass surgeries. Therefore, its effectiveness in obesity is high. For the same reasons, the risk of complications is also higher at the same rate.
