Turkey's Center for Obesity & Metabolic Surgery

SLEEVE GASTREKTOMİ


Today, surgery is the most common surgery in obesity. In this operation, about 3/4 of the stomach is removed and the stomach is brought into the shape of a long tube. Decreased stomach volume causes early satiety and weight loss.

The secretion of Ghrelin (appetite hormone), which is secreted from the fundus mainly by this surgery, is greatly reduced. People who feel hormonal after appetite decrease their need to eat less.

Frequently Asked Questions About Tube Stomach Surgery

Tube Stomach Surgery What is removed?

Sleeve gastrectomy is an operation in which the longitudinal ¾ of the ” Tube Stomach Surgery ” is widely used. The stomach removed from this surgery is between 800 ml and 2 liters. In other words, the volume of the extracted mide is 4 to 10 cups of water. On the other hand, the remaining volume is between 80 and 120 ml. This amount is about half the volume of a water glass.

In Tube Stomach Surgery, there are 2 mechanisms to lose weight: mechanical reduction with reduction of gastric volume and weight loss due to reduction of stomach movements, weight loss after a hormonal change due to removal of stomach tissue producing a substance known as Ghrelin. Ghrelin is a 28 amino-acid peptide protein produced in the upper part of the oxytocin called the fundus. It is a potent orexigenic peptide that is regulated by the activation of receptors in the hypothalamus or pituitary region of the brain. In each gram of the stomach fundus, there are 10-20 times more ghrelin than the twelve finger intestines. In other words, 80% of the whole body secreted ghrelin hormone is secreted from the part we call Fundus, which is removed by Type Stomach Surgery. In the Tube Stomach Operation, the ghrelin-produced mendi- nous fundus region is removed, resulting in decreased appetite and weight loss.

What is Tube Stomach Surgery’s Other Obesity Surgery?

1-It can be done laparoscopically (Closed), so wounding is faster, pain is less, and the length of stay in the hospital is shorter.

2-The capacity of the scale is reduced but its functions are not changed so many food groups can be consumed less.

3-Ghrelin (hunger hormone) produced by removing the fundus region of the appetite is reduced and weight loss occurs.

4-Doodling syndrome is prevented because it is called a pilor and prevents the lid mechanism from slowing down from the middle of the food and thus facilitating digestion. This syndrome can be especially caused by gastric bypass surgery. As the food has left the pancakes lately, there is a feeling of fullness for a longer time.

5-Avoiding intestinal by-pass; the risk of bowel obstruction, marginal ulcers, anemia, osteoporosis (bone erosion), protein and vitamin deficiency

3-In patients with very high VKI (VKI & gt; 50 kg / m 2) suitable for bilateral operations, the first stage gives very effective results for surgery.

4-In patients with chronic bowel disease such as Crohn’s disease, intestinal bypass is at high risk. Tube stomach surgery can easily be done in such patients.

5-Tube gastric surgery is an operation that can be recycled. If this surgery is less than 8-10 years after the surgery, weight gain can be recovered. In this case, a second operation can be converted to bypassa and doudenal switch + biliopancreatic diversion surgery and the person will lose weight again.

What are the disadvantages of tube stomach surgery?

1-Tube The expected weight loss with gastric surgery is mostly achieved. However, the ideal weight can not be reached in people who are especially called ” Sweet Eater ” and have sweet sweetheartedness. In this case, either dietary habits can be changed by a dietician, or diversion operations such as duodenal switch can be applied. Thus, weight loss is achieved again.

With 2-tube gastric surgery, 40-60% of diabetes and 60-70% of hypertension are improving and there is no need to use drugs. However, in such chronic diseases, the Mini Gastric By Pass, another version of the Roux-en-Y surgery, which is called the Gastric Bypass, does not need 90% of the drugs much more effectively.

How does weight loss after Sleeve Gastrectomy (Tube Stomach) go?

After this surgery, there is a slight weight loss of 15 Kg in the first month. In the following 2 months, 10 Kg loss, 3 months 5-6 Kg, and in the following months, 4-5 kg ​​weight loss per month. It is not necessary to lose weight too fast anyway. Very rapid weight loss can cause partial sagging especially in people above 150 Kg on the skin. In addition, rapid weight loss can negatively affect the body’s vitamin and mineral balance. The goal should be to reach 70-80% of ideal weight in 6 months to reach ideal weight in 2 years.

How should nutrition be done after Sleeve Gastrectomy (Tube Stomach) surgery?

On the first day after surgery, a colored liquid is drunk and leakage test is performed. If the possibility of leakage is very low, then after making sure of this test, first sip water and then fruit juice, non-greens, compote and fruit teas are started. On the second day, again, soup without a grain, 3rd day ayran and yogurt are started. According to the harmony of the person, additional food is added to this feeding regime every day. Boiled vegetables and fruit can be taken in a week. Second week eggs, 3 weeks fish, 4th week dishes can be misunderstood. After 6 weeks of operation, all kinds of food are released except for chocolate.

Is the sleeve inserted after the operation of Sleeve Gastrectomy?

The tube is not attached to the end of the stomach operation. We think that it disrupts patient comfort and does not benefit either. However, this depends on the preference of the obesity physician and the medical approach.

Is it necessary to take vitamin medicines after Sleeve Gastrectomy (Tube Stomach) surgery?

Since the gastrointestinal system after tubal gastrectomy functions almost as old as it is, deficiencies of these vitamins and minerals are often not encountered. However, if it is unlikely, I recommend taking a tablet containing vitamins and minerals daily to prevent the development of deficiency.

What should we do if we lose weight after the operation of Sleeve Gastrectomy (Tube Stomach) and start to get it again?

Tube stomach surgery can provide long-term effective weight loss, even if it is in the nadence, after years of weight loss, or even a certain amount of weight gain again. In this case, the tube may have begun to grow back in stomach volume reduced by stomach. It is tried to be understood whether or not the images obtained by drug administration in the mouth with a scopee device or a tomography device are enlarged and enlarged. If the stomach is enlarged, it will be prevented from gaining weight by performing Gastric By Pass or Mini Gastric By Pass surgery.

What are the Risks of Tube Stomach Operation?

As with any surgical procedure, there are potential risks and potential complications in Tube Stomach operations. Obesity surgeries have been used for many years by experienced and knowledgeable ozesite surgeons and they reduce the problems to be experienced later. Tube from osseous surgeries The risks that can be encountered in gastric surgery are;

General risks that can be seen in patients with obesity surgery.

Leak Occurrence; Obesity surgeries are made with tools called stapler made of titanium. If these stapler wrinkles and leak, stomach inflammation of the abdomen, infection and abscess risk. In the published scientific publications, fugitive risk is reported at rates ranging from 2 to 4%. After surgery and after surgery, it is checked whether there is leaking with colored liquids which are filled in the mouth before going to the oral feeding. If there is a leak or is suspicious, it is easily repaired if it is noticed in the operation. However, if it is noticed after the operation, it can be treated by inserting staples or stents into the stomach with the endoscopic device if it is noticed before the food intake or after the feeding.

Bleeding on the Stapler Line; There is a risk of bleeding in the stapler line less than 1%. It can usually be done without any treatment. At the end of the operation, a drain is placed into the abdomen and a reservoir is attached to the outer end of the collector. If there is excess blood in this reservoir, bleeding can be a doubt. In this case, blood may be required. However, such a situation is very rare.

Infection; People with Diabetes Mellitus ” Diabetes ” may have this risk. In this case, the infection is controlled by antibiotics and drainage methods. In addition, these patients may develop wound, paralysis and pulmonary infections of other systems.

Embolism; The formation of obesity emboli (clots) increases the risk. If obese birds are in another operation, there is the same risk. The risk of embolism can be fatal and this risk lasts 20 days after surgery. This risk is less than 1% after obesity surgery. These are the most important and serious complications; may cause sudden deaths. To reduce the risk of embolism, blood thinners are started 12 hours before the operation by injecting needle under the skin and continue for at least 5 days. However, people who we refer to as super-obese and whose body mass index is over 50 can continue to use blood-thinning drugs for up to 10 days. Another application to reduce the risk of embolism is to wear embolic stockings

Respiratory Problems; Particularly in smokers, respiratory problems can be experienced because of the lung capacity already reduced. For this reason, at least one week before the operation is suggested to leave the cigarette. Walking and breathing gymnastics are performed to prevent respiratory problems and to take the sputum early. Devices such as respiratory strengthening trifle are used.

Incisional Hernia; Especially in the case of tube stomach surgery, because the hole in which it is extracted is slightly larger, it can carry a risk for hernia. This risk is less than 1%. The incision line is stitched to prevent herniation.

Small bowel obstruction; Folding (sticking) around the scar tissue after open bariatric surgery may block small intestinal passages. Another cause of bowel obstruction is incisional hernias. The risk of intestinal obstruction after laparoscopic bariatric surgery is very low. The problems that may occur with this can also be repaired laparoscopically.

Organ injuries; Because the spleen, liver and intestines are close to the operation shaft, they may be injured during the operation. If the injury is noticed during surgery, it is treated surgically, but splenectomy may be necessary if splenic injury can not be controlled.

Bowel punctures; There may be punctures or splits in the stomach and intestines during surgery. If puncture occurs, it is repaired laparoscopically. However, if this situation is not noticed, advanced treatment techniques and intensive care are needed. In such situations, life is a danger.

Death; Laparoscopic Sleeve Gastrectomy (Tube Stomach) risk of death is 1/1000. This risk, for example, is the risk of appendicitis surgery or biliary-side surgery. There is a risk if every surgery performed under natural anesthesia is low. This risk is acceptable in obesity surgery.

Special risks for Sleeve Gastrectomy (Tube Stomach) surgery;

Vitamin – Mineral Deficiency; Sleeve Gastrectomy is very rarely caused by lack of vitamins and minerals because the intestinal anatomy is not altered in any way. Vitamin tablets are prescribed to prevent this. Vitamin deficiency, especially B1, B12 and D, is more common than other vitamins. After the obesity surgery, these vitamins and trace elements should be measured by coming to regular controls.

Hair loss; After a few months of obesity surgery, thinning of the hair follicles and slight powder casting may occur due to rapid weight loss. This is usually a temporary problem. The cause is due to inadequate protein uptake and lack of trace elements. We hardly encounter this situation.

Weight Overeating Failure; Obesity can result in failures in the nadence of weight loss after surgery, especially in people with sweet food enthusiasm called Sweet Eater. For this reason, by-pass surgeries are preferred, which can provide more effective weight loss in those with sweet food adulthood.

Sag; This is usually a problem. High amounts of weight loss can be followed by skin sagging and wrinkles. The amount of weight given affects skin elasticity, age, amount of spores made. When necessary, our clinics perform plastic and reconstructive surgery. We have a specialist plastic and reconstructive surgeon team for these surgeries.

Conversion of Closed Surgery to Open Operation; Occasional operations can be turned into open surgery with occasional safety reasons.

How much weight can I lose after my tube operation?

Tube is expected to give more of the excess weight in 2 years period after gastric surgery. Success in weight is directly proportional to the patient’s compliance with the post-operative diet and exercise program. It is expected that a person with 130 kg before tube gastrectomy will lose 40-45 kg in 6 months. After this surgery, 15 kg in the first month, 8-10 kg in the 2nd month, 5-6 kg in the 3rd month and 4-5 kg ​​in the following months is a normal process.

Is Tube Stomach Surgery Suitable for Me?

World Obesity Surgery Association has made some suggestions for obesity surgery. According to this, Obesity operations are more than 35 kg / m2 and body mass index is more than 40 Kg / m2, which is a recommended surgery for patients with accompanying disease such as diabetes, policystic over, reflux esophagitis, hypertension. In addition to the weight criteria, there should be no advanced psychiatric disorder. People who we call Sweet Eater are recommended for gastric bypass surgery. Also, in recent years these borders have been partially stretched, but they have to be older than 16 and smaller than sixty-five.
Ameliyat Öncesi Hazırlık;

What is the process for Tube Stomach Surgery?

You do not need to wait for your obesity surgery. After the first examination some blood tests are done. Chest x-rays and heart electrography are taken in the elderly over 40 years. After the examination of the obesity surgeon, he sees the patient in Endocrinology and Anesthesia specialists.

What tests do I need to have before my tube surgery?

Routine Biochemistry

I hemogram

Elisa

PTT – PTZ

cortisol

Dexamethasone Suppression Test

ST3 / ST4 / TSH

PAAL

ECG

When should I leave the cigarette before Tube Stomach Surgery?

It is necessary to quit smoking at least a week before the tube operation to avoid lung problems before surgery.

Is it necessary to leave alcohol before Tube Stomach Surgery?

Alcohol is especially harmful to the liver. It is recommended to drink alcohol 15 days before the operation because it can show harmful effects on the anesthetic drugs.

How many days before the tube stomach surgery should I go to the hospital?

We usually recommend to go to the hospital 1 day before the surgery for obesity. However, on amelita day it is possible to sleep in the hospital.

How long do I have to eat or drink before tube surgery?

A special diet is not required before obesity surgery. After 12 o’clock the night before the operation, food and drink should be left completely. However, medicines used especially for chronic diseases such as blood pressure drugs should be drunk in the morning with a few sips of water.

How long does Tube Stomach Surgery last?

Tube stomach operations usually last up to 30-75 min. It takes about half an hour for the patient to prepare for surgery and to be hounded for half an hour and the patient to be adapted after surgery.

What should I bring with me when I come to bed in the hospital?

If you are going to the hospital before surgery, nightly, pajama, and any drugs you use regularly, bring them with you. Enboli Surgery – Triflo, which should be taken prior to tube stomach operations, is provided for our patients by our clinic.

I use low dose aspirin, should I interrupt?

Low doses of aspirin such as coraspine, displis, ecopirin should be given 5 days before the operation. In order to prevent clotting instead of these drugs, the blood thinner needle is started 12 hours before the operation and continues for 5 days after the operation.

What kind of measures are taken by Emboli?

One of the greatest risks of obesity surgery is emboli, which is clotting. To minimize the risk, the blood diluters, who started the embolization surgery preliminaries, continue to wear embolistic socks before surgery.

How long before tube surgery is done in the operating room?

About half an hour before the surgery, the patient is taken to the operating room.

Did the urine plug before the tube stomach operation?

Before all obesity surgeries, the urine sonde is inserted and the kidneys are studied and fluid is followed.

Who is on the surgical team?

The surgical team;

Obesity Surgeon

general surgeon

Anesthesiologist

Anesthesia Hemşiresi

Operative Technician

Assistant Staff

How long does it take for my tube to wake up after my stomach operation?

Tube after stomach operations, according to the patient changes in the wake up about half an hour of the patient is expected to come to the heart.

Can I get a lot of pain after my tube stomach operation?

Obesity surgery is done laparoscopically, ie closed method, so there is no severe pain. In addition, immediately after the operation, painkillers are made before leaving the operating room. During the course of the painkiller’s influence on the patient; there may be some pain in the pain threshold dose that will change from the patient to the patient.

Is Naso Gastric probe inserted in Tube Stomach Operation?

Nasogastric tube inserted during surgery during tube gastric surgery is withdrawn before the patient wakes up. So there is no discomfort to the sonde.

Will I need a companion after Tube Stomach Surgery?

After the obesity surgery, we advise you to be accompanied by the patient especially for the first few days.

Does the tube get drained during gastric surgery?

After all obesity operations, resistance is attached. Diren is withdrawn after 4-5 days. Stretching is a painless process.

How long will the patient stay in the hospital after surgery on the stomach?

The duration of hospital stay after tubal surgery varies, depending on the healing process of the patient, but usually ranges from 3 to 5 days.

Should I stay in intensive care after surgery?

The need for intensive care after obesity surgery is a decision given with the anesthesiologist. Our team is in need of intense attention. After the patient has recovered from the wake-up after the operation, he is taken to the service bed.

How Long After Tube Stomach Surgery Can I Get Pregnant?

Tube after stomach surgery after reaching the ideal weight in the second year after the pregnancy is proposed, there is no inconvenience to get pregnant before. It is important that vitamins and minerals deficiencies are entered into the pregnancy period and this is continued.

How long can I continue sexual life after tube stomach surgery?

It is necessary to avoid sexual activity during the first 2 weeks after the obesity surgery and the recovery process continues.

How long does the tube last after losing weight after surgery?

After tube surgery, weight loss continues for about 2 years. In some cases, patients may be able to give their excess weight before completing this process and lose weight earlier. The ideal thing is to lose weight regularly.

From When I’m Out of Hospital When should I come to checkups?

After obesity surgeries, I recommend surgery for control of the operation site 10th day after leaving the hospital. In the following period, for some tests and controls, one year, three months, six months, one year and the following yearly control are required from the operation.

What drugs will be on prescription after withdrawal from hospital and how long will I have to continue these?

Antibiotic

Painkiller

Vitamin tablet

Stomach protector

How long does it take for my tube to return to normal life after surgery?

Tube after stomach surgery, if the desk job is done 15 days after work is recommended to return to work. In particular, people who work in jobs that require physical work may start working after 3-4 weeks.

Can I get a report for post-operative rest?

Tube stomach operations are given a rest report for an appropriate period after surgery.

How long can I take a bath after Tube Stomach Surgery?

You can have a bath the next day after leaving the hospital. The Buddha coincides with the 5th and the 6th day.

After Tube Stomach Surgery Do I Have to Use Vitamin Pills?

After obesity operations, especially those who lose weight fast, vitamin and trace element minerals such as zinc, selenium can be deficiencies. Tablets containing vitamins and minerals are prescribed to prevent this situation.


Clinic Phones

0 (312) 286 44 63 - 0 (312) 286 44 64