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Gastric Bypass
Gastric bypass surgery is primarily based on the direct diversion of food to the last segment of the small intestines without running through the stomach and a significant portion of the small intestines.
There are various types of gastric bypass surgery: these are Roux-en-Y gastric bypass and biliopancreatic diversion with a duodenal switch. These methods aim bypassing foods directly to the duodenum or initial segments of the small intestine with no or minimal contact of foods to the stomach by removing a part of the stomach or without need to remove a part of the stomach. Recently, those surgeries can be performed with laparoscopic methods. Comparing to sleeve gastrectomy, surgery-related complications are more commonly accompanied by long-term postoperative metabolic problems in these methods. More weight loss is achieved and can be maintained up to 2 years.
Sleeve Gastrectomy
This is one of the most common methods used for obesity surgery in our hospitals since it is easy to practice and leads to less complications, although it is as effective as other complicated surgical methods. In this method, 80 to 90% of stomach is removed and transformed into a tube. This surgery takes about one to two hours and is performed with closed (laparoscopic) method. Hospital stay is two to three days. Patients can start consuming normal foods after they eat liquid foods for two weeks and soft foods for the subsequent two weeks after the surgery. Vitamin supplements may be required. ‘Ghrelin’ hormone, which is released from fundus of the stomach, is thought to be responsible for overweight and obesity. This hormone regulates the hunger. In this surgical method, fundus of stomach is totally excised and this helps to diminish appetite and lose weight. Gastric sleeve surgery utilizes both mechanical effects (reducing the volume of the stomach) and hormonal effects to help losing the excess weight. Thus, both volume of the stomach is reduced and the appetite is controlled. No problem is faced in digestion of food, since small intestines are left untouched.
Thanks to sleeve gastrectomy, patient loses excess weight and therefore, the health risks arising out of the obesity are eliminated.
There are some criteria for sleeve gastrectomy to be performed. First of all, the patient should fail optimal or target body weight despite diet and exercise. Just as the case for all health issues, surgery should be considered as the last option. The commonly accepted two criteria are high BMI (>40) or lower BMI (35-39) accompanied by coexisting obesity-induced serious health conditions.
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