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Tube Stomach Surgery (Sleeve Gastrectomy)

What is Morbid Obesity?
Obesity to a degree that impairs one’s health is called morbid obesity. The word morbid here is used in the sense of disease.

What is the Morbid Obesity Limit?
Although it is not clear which type and degree of obesity impairs our health, a number called body mass index (BMI) has been defined in order to make this subject easy to understand. If this number is over 40 or if it is over 35 in the presence of a disease such as diabetes or high blood pressure, the person is considered to be morbidly obese, that is, overweight at the disease level. Recently, the view that BMI alone is not sufficient to describe unhealthy obesity has become widespread. Although your body mass index is below 40, we can talk about unhealthy obesity, especially in people with abdominal fat, that is, in people whose waist circumference is above normal. Such people are much more likely to have a larger than normal liver and fatty liver.

How to Calculate Body Mass Index?
It is very easy to calculate the body mass index used to define obesity. You will divide your weight by the square of your height. Let’s say you weigh 80 kilos and are 1.60 tall. 1.60 squared (1.60X1.60) is 2.56. It represents a body mass index of 31.25 kilograms/square meter, which comes out when you divide 80 by 2.56.
Underweight………..18.5 kg/m²
Normal weight……….18.5-24.9 kg/m²
Overweight……………25-29.9 kg/m²
Fat (Light)……….30-34.9 kg/m²
Fat (Medium)………..35-39.9 kg/m²
Fat (Morbid)………..40 kg/m²

How Morbid Obese Lose Weight?
Diet is arguably the most effective treatment for obesity that we know of. When you add a healthy lifestyle and sports to this, the best results are undoubtedly obtained. At the same time, we know very well that the feeling of hunger is one of the strongest impulses in the structure of living things. None of us can accept the interruption of any meal before we are satisfied. Imagine doing this for the rest of your life. This is a very heavy price. What can we promise to do in life, even if we don’t want to! Consider someone with severe obesity. The body weight that needs to be lost in order to reach the ideal weight may be as much as 60 or even 90 kg. This is a second problem. The destination you need to reach is far away. No matter how difficult it is, a more important problem waiting for those of us who have lost that much weight and achieved their goal is to maintain this weight for life. I’m not sure how realistic our demand for a lifetime diet and exercise from someone with morbid obesity is.

Morbid obesity is a very difficult situation to eliminate with diet, exercise and psychological help.

Who Is Tube Stomach Surgery Performed?
People with a numerically greater than 40 body mass index or over 35 in the presence of co-morbidities may consider surgery when other methods are not successful in losing weight. Of course, we would like to consult with a psychiatrist or psychologist before deciding on this surgery. Because there are some eating urge disorders that can cause problems even after surgery.

What are the Risks of Tube Stomach Surgery?
I think it may not always give a healthy result to draw a roadmap with only numbers while making the decision of surgery for a morbidly obese person. For example, shouldn’t someone who has a body mass index of 38, who has been dieting and exercising for a long time, losing weight and regaining it, not have surgery just because their body mass index is not over 40? Or should someone who has diabetes requiring insulin use and a body mass index of 34 not have surgery? It is difficult to answer these questions with the current criteria at our disposal. The American Society for Metabolic and Bariatric Surgery felt the need to make an additional statement on its website in recent months, as such people are frequently encountered in practice. In this statement, based on the results of a total of 57 studies based at Oxford University, which included 900,000 people, the risk of death increased by 30 percent for every 5 points in people with a BMI over 25. It has been observed that the risk here is related to stroke, heart attack and sugar, regardless of age.

As a result, it is thought that life expectancy is shortened by 3 years, even in those with first degree obesity, that is, BMI between 30-35. The American Society for Metabolic and Bariatric Surgery says, “In such a case, we should not deprive people of these methods, who are below the classical BMI figures, but who can benefit from surgery due to their special conditions and whose life span can be extended.”

How is Tube Stomach Surgery Performed?
Thanks to the developing technology, laparoscopic, that is, closed method, is done with special tools through a few small holes opened in the abdominal wall. One of the most frequently applied techniques today is sleeve gastrectomy.
How Many Days Will You Stay in the Hospital After Tube Stomach Surgery?
A 48-hour hospital stay after surgery is considered sufficient.
When is the Return to Work After Gastric Sleeve Surgery?
He can return to his daily life on the third day, and on the seventh day if he does not use heavy physical force.

What Is The Weight Loss Rate After Gastric Sleeve Surgery?
Patients usually share with us that they have lost 4-5 kilos excitedly when they are discharged. The first month is the period when they lose the fastest weight. They lose about 50-60 percent of their excess weight during this period. The weight loss process continues slowly until 18 months. At the end of 18 months, they get rid of about 70 percent of their excess weight. Afterwards, if the person supports this process with diet and sports, he can even reach his ideal weight.

Why is Tube Stomach Surgery Performed?
The reason why this method is very preferred is that it provides less food and satiety, as well as the fact that the food proceeds naturally within the digestive system. Since this does not cause much problems in the absorption of beneficial vitamins and minerals, the need for lifelong drug use is less.

Tube Stomach Surgery is Performed by Laparoscopic Method
Thanks to the developing technology, the surgery is performed by laparoscopic, that is, closed method. This allows them to heal quickly. So much so that they can stand up and walk 6 hours after the operation. Contrary to usual, they no longer wake up with a nasty probe in their noses after surgery. The next day they drink water and apple juice. On the third day, they can leave the hospital and return to their normal lives.

Is Weight Gained After Tube Stomach Surgery?
We explain that the type of food preferred by the patients after the surgery is also effective in the success of the surgery. You can fill your shrunken stomach capacity with protein and carbohydrates. We rarely encounter problems of not losing enough weight, especially in people who have a carbohydrate-heavy diet and are not compatible with us after surgery. In this case, we can add the second bypass surgery. After this operation, called duodenal switch, there is almost no problem such as gaining weight or not being able to lose weight again.

What is the Success Rate of Gastric Sleeve Surgery?
With gastric sleeve surgery, effective weight loss is achieved at rates of up to 90-95% in the first 1-2 years. Lack of a good psychiatric evaluation may be due to the small number of patients in this unsuccessful group. Of course, there is the problem of regaining weight over the years. Even if you do not return to your old weight, you can go 10 kilos and sometimes 20 kilos above the lowest weight you have dropped.
What is the Age Limit for Tube Stomach Surgery?
This surgery is suitable for anyone who has a problem of morbid obesity, that is, who is overweight and who cannot get rid of this problem permanently with methods such as diet and sports. If we need to set some limits, these surgeries should be performed between the ages of 17 and 65. Also, it may not be suitable for those with advanced health problems who cannot receive anesthesia. Finally, it may not be suitable for people with alcohol or drug addiction or psychiatric problems.

When is Tube Stomach Surgery Performed?
An experienced dietitian and psychologist also participate in the interview with the patient. The most important criterion when deciding on surgery is that they request it from the physician. In other words, it is very important how important it is for them to be underweight or how much of a problem being overweight is in their lives.

How Is The Preparation Before Gastric Sleeve Surgery?
After deciding on surgery, general blood tests of the heart and circulatory system, lungs and some hormone measurements are made. Some patients are brought into the sleep lab to detect sleep apnea syndrome, a very common problem. Those with advanced sleep apnea complaints are prepared for surgery at home with an assisted respiratory support device for one or two months before the operation.

Psychological evaluation is also an application that we always do. We make patients who we think cannot evaluate this surgery and the life after it very well or do not fully understand us, meet with our psychologist. Sometimes we may encounter an eating urge disorder. In this case, we recommend that they go on a diet with our psychologist before the operation.

Should Those Who Have Tube Stomach Surgery Have a Diet?
Diet is the most effective way to lose weight. We are already performing the surgery so that they can diet. Of course, they can easily make their diets as they become satiated after the surgery. Since their stomach volumes are reduced, we want them to be fed with higher quality food, that is, protein-based.

Should You Do Sports After Tube Stomach Surgery?
We recommend walking for the first 2 months, gymnastics such as fitness and pilates from the third month. This both facilitates weight loss and reduces sagging that may occur in the body. Swimming is the type of sport we recommend the most.

Things to Consider After Gastric Sleeve Surgery

The patient should learn the feeling of satiety very well after the surgery and pay attention to it.
Take extreme care in chewing and turn to foods richer in protein
In the future, it should also determine the foods that keep oneself full for a longer time.
In the first and third months, some blood tests should be done to check whether there is any vitamin or mineral deficiency.
Doing regular sports, especially swimming, will minimize sagging due to excessive weight loss in the body, while the body will also provide a balanced weight loss. Regular exercise should be done
Avoid excessive alcohol intake after surgery.
What are the Benefits of Tube Stomach Surgery?
The person who gets rid of most of the excess weight in the first six months after the surgery makes great gains in terms of both social and physical health, condition and general health.
Many people who suffer from sleep apnea at night recover from it.
Women who hesitated to enter the stores because they could not find suitable size clothes for years return to the shopping environment with pleasure.
First of all, the patient’s mood changes
First comes your self-confidence.
Your feet are stronger
Your health improves; have diabetes, your risk of getting cancer is reduced
You get rid of mobility restrictions
You can easily go up and down stairs
you can run
You will enjoy being born again