Obesity Surgery: What is it, what diseases does it treat, what are the treatment methods?
Today, obesity has become a disease that threatens public health. The prevalence of obesity has increased in all age groups, especially children, and due to this increase, obesity-related diseases have become more common. Obesity is a condition that seriously threatens cardiovascular health. Obesity must be treated in order to prevent obesity-related diseases.
What is Obesity Surgery?
Obesity surgery is weight loss surgery performed on people who have clinical obesity problems and are at risk of health problems related to this excess weight. Obesity surgery, also called bariatric surgery, is applied to patients who cannot lose weight to the targeted extent with diet and exercise. With obesity surgery, in some methods, the person’s eating capacity is reduced, while in other methods, the amount of food absorbed from the stomach and intestines is reduced. In some types of obesity surgery, both procedures can be performed simultaneously.
Although obesity surgery is a very effective method for obese people to lose weight, it also brings with it some side effects. To protect against the risks of surgery, doctors usually first apply a diet and exercise program to people. Obesity surgery is considered for patients who cannot lose weight to the desired extent despite this program. Obesity surgery patients’ attention to their diet and regular exercise for the rest of their lives contributes to maintaining the person’s ideal weight.
What Diseases Does Obesity Surgery Treat?
Obesity is a complex disease that involves excess fat in the body. Although some people see obesity as a cosmetic problem, obesity is a medical condition that can form the basis of many diseases. Therefore, obesity needs to be treated. Obesity surgery mainly deals with obese patients. Obesity surgery is also included in the treatment of people with obesity problems such as diabetes, heart disease and sleep apnea.
What are the Obesity Surgery Treatment Methods?
There are several different types of surgeries performed in obesity surgery. The type of surgery to be performed varies depending on many factors such as the patient’s age, weight, and obesity-related disorders. All operations in obesity surgery are performed under general anesthesia. In other words, the patient does not feel anything during the procedure. In addition, patients are intubated during surgery and their breathing continues with the help of devices.
Most of the surgeries in obesity surgery are performed by the laparoscopic method, also known as closed. In this method, several small holes are opened in the patient’s abdomen, and thin tube-shaped devices with a camera at the end are inserted through the holes, which enable operations inside the abdomen. The surgeon performs the procedure with the help of these devices. In the open method, the patient’s abdomen is opened with a large incision and the procedure is performed.
The different types of surgery performed in obesity surgery are as follows:
Gastric Sleeve Surgery
In this method, also known as sleeve gastrectomy, approximately 80% of the patient’s stomach is removed. The remaining stomach piece is shaped into a long, thin tube. In this way, the stomach becomes smaller and cannot hold as much food as before. In addition, the ‘ghrelin’ hormone, secreted from the stomach and known as the hunger hormone, is produced less. Thus, the patient’s appetite decreases after the surgery. Gastric sleeve surgery helps patients lose large amounts of weight. One of the biggest advantages of this type of surgery is that it requires a shorter hospital stay compared to other surgical methods.
One of the most commonly used methods in bariatric surgery is gastric bypass. This surgery is basically done in two steps. First, a small part of the upper part of the stomach is separated from the rest of the stomach. Then, the initial part of the small intestine to which the stomach is connected and the rest of the intestine are divided into two parts. The part located in the middle of the intestine is connected to the small part separated from the stomach. The remaining large part of the stomach and the initial part of the intestine are added to the structure near the middle of the intestine. Since the stomach size will decrease with gastric bypass surgery, the patient will be satisfied with less food in one sitting. In addition, nutrient absorption decreases as the consumed foods bypass the first part of the intestine.
Robotic surgery is the method in which various obesity surgeries, especially gastric bypass, are performed. In robotic surgery, the surgeon does not perform a procedure directly on the patient. Instead, the patient is placed under a large, multi-functional device called a robot. The surgeon uses the control keys on this device to move the arms that will perform the procedure on the patient. The difference between robotic surgery and open or laparoscopic surgery; It allows the surgeon to act more precisely.
Gastric balloon procedure is a method in which a balloon-like device is placed in the patient’s stomach. This device, placed in the stomach, reduces the patient’s stomach capacity and contributes to quick saturation. Gastric balloon is not a frequently preferred method among obesity surgeries.
Who is Obesity Surgery Suitable for?
Obesity surgery does not include procedures that can be applied to everyone. In order to undergo these surgeries, the patient must meet certain criteria and accept surgery-related complications.
The patient groups that can generally be evaluated for obesity surgery are as follows:
- Those with a Body Mass Index (BMI) of 40 and above (extreme obesity)
- Those whose Body Mass Index (BMI) is between 35-40 and have health problems such as obesity-related diabetes and sleep apnea
- Those whose Body Mass Index (BMI) is between 30-35 and have serious health problems due to obesity
Even if the patients meet the criteria in terms of BMI, the doctor decides whether they can undergo obesity surgery. The severity of the patient’s obesity-related health problems affects this decision.
The most common diseases associated with obesity are as follows:
- Heart disease
- Sleep apnea
- type 2 diabetes
- fatty liver disease
Patients must be ready to make permanent changes in their lifestyle in order to be a suitable candidate for bariatric surgery. If the patient does not follow the diet and exercise program recommended by the experts after the surgery, the success achieved with the surgery will not be permanent.
What are the Risks of Bariatric Surgery?
As with every major interventional procedure, there are some risks associated with obesity surgery.
Risks that may arise due to the surgical procedure are as follows:
- excessive bleeding
- Development of side effects to anesthetic substances
- Blood coagulation
- Heart and lung problems
- Intestinal leakage into the abdomen
Complications that may develop in the long term due to obesity surgery:
- intestinal obstruction
- Dumping syndrome with symptoms such as nausea, vomiting, diarrhea and dizziness
- low blood sugar
- Leakage from the seam line (Leak)
Complications that develop both during the surgery and in the long term due to the surgery can rarely lead to the death of the person. Therefore, the decision for obesity surgery should be made carefully. In terms of intervention in emergency situations, it would be beneficial to perform the surgery in a well-equipped hospital.