Hello, I’m Dr. Abdulcabbar Kartal. Basically, I would like to explain the two bariatric surgical methods we apply. First one is the sleeve gastrectomy method, the other is the gastric bypass method.
Years ago, the most common method used was gastric bypass surgery. However, in the last 30 years, a method called sleeve gastrectomy has been developed and it has become the most common surgical method performed all over the world. In sleeve gastrectomy, we remove most of the stomach with laparoscopic method and leave a stomach as thick as the esophagus behind. In this method, individuals are less hungry because the stomach volume is reduced and the fundus and corpus part where the appetite hormone is secreted, is removed, and the volume is reduced, so they eat less and lose weight. A hunger hormone called ghrelin is secreted in the fundus and corpus section that we take out. Since this part is removed, the appetite of the patients decreases. Losing weight becomes easier because appetite and calorie intake decreases.
The other is the gastric bypass method, a slightly more difficult surgical technique. A very large part of the stomach is removed. A new way is made by pulling a part from the small intestine into the newly created gastric pouch. By connecting the small intestines in different proportions, a bypass is made between the upper and the lower part of the small intestine. The possibility of digestive enzymes to meet with food is delayed, so less food is eaten because the volume decreases, and absorption is disrupted because the food we eat meets with digestive enzymes later and patients lose weight rapidly.
Both methods have been used for a long time and have proven to be effective, safe and successful in losing weight. Gastric bypass method is a more complex surgery that takes a little longer than sleeve gastrectomy. Sleeve gastrectomy is a method that is a little easier, the operation time is slightly shorter and less complications develop. Patients lose 65-70% of their excess weight, they usually stay in hospital for 2-3 days and discharged.
In sleeve gastrectomy, bleeding can be seen at a rate of 1-2% and it is extremely easy to control. Leakage can be seen at a rate of 2-3% and since you do not disturb the anatomy of the gastrointestinal system, it’s more physiological, and causes less vitamin and mineral deficiency in the long term. Absorption disorder occurs in the gastric bypass method. Vitamin and mineral deficiency will manifest due to this disorder. This doesn’t happen in sleeve gastrectomy. Lifelong follow-up and vitamin support will be required in gastric bypass method. The probability of complications such as bleeding, leakage and death is slightly higher compared to sleeve gastrectomy. However, the patient loses more weight with the gastric bypass.
In both methods, weight is lost rapidly, weight-related problems of the patients improve but if the lifestyle does not change, it is possible to regain the weight after a certain period of time. Currently, the best weight loss method in the world is surgical methods. It is superior to non-surgical methods and this has been proven.
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