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Obesity is the excessive and abnormal accumulation of fat in the body with weight gain that impairs health. While calculating obesity, body mass index is used. A person with a body mass index over 30 is considered obese and a person over 40 is considered morbidly obese. While excessive weight gain threatens human health to a great extent, it can also cause restriction of movements and serious diseases. In the fight against obesity, there are many rooted hospitals and top gastric sleeve centers in Turkey which provide this treatment carefully. Therefore these clinics have the top gastric sleeve surgery surgeons in Turkey working with their expert team.
Obesity, which is becoming increasingly widespread in the world and in Turkey, significantly affects the quality and duration of life. However, obesity is a disease that can be treated with both surgical and non-surgical methods. Turkey is one of the most preferred countries for obesity surgeries due to its geopolitical location, affordable sleeve gastrectomy prices/cost and having experienced gastric sleeve surgeons in Turkey who treat obesity. Especially patients who have tried to lose weight in natural ways countless times come to Turkey and/or Istanbul for obesity surgery. Gastric sleeve surgery is the most commonly used method in the treatment of obesity. Gastric sleeve surgery changes the patient's eating habits by shrinking the stomach. Numerous hospitals in Istanbul apply this procedure successfully and discharge patients in a short time. Apart from Istanbul, high quality surgeons perform bariatric surgery on patients from all over the world in other Turkish cities such as Izmir, Bursa, Ankara and Antalya. These specialist doctors decide on the right treatment method after examining the patients. Patients generally refrain from surgery in the treatment of obesity, but doctors also provide the necessary psychological support to patients in these cases. Especially in Istanbul, there are hospitals that only treat obesity and are specialized in obesity. The best gastric sleeve surgeons in Turkey manage weight loss in a controlled manner by closely following the patients not only during the operation process but also in the post-operative period. In order to have a successful gastric sleeve surgery in Turkey, it is important that patients should not give misleading information in the preliminary information that they send to the doctors. Although the necessary controls are made before sleeve gastrectomy surgery, a health problem that may be overlooked may pose risks. For this reason, it is important that you need to tell your surgeon about your known health problems when booking sleeve gastrectomy surgery.
Gastric sleeve in Turkey is performed under general anesthesia. During the operation, the surgeon opens 4-5 incisions in the patient's abdomen and then enters these incisions with the help of special devices. Surgery is performed laparoscopically and approximately 80% of the stomach is removed. The biggest advantage of this method is that there are no large incisions in the stomach and therefore less postoperative pain. Gastric sleeve surgery has a 99.7% survival rate. Reputable gastric sleeve surgeons in Turkey help their patients to lose weight quickly, while at the same time taking the necessary nutrients and providing them with a healthy diet.
Making the right preparation before gastric sleeve surgery reduces the risks in the surgery, allows the patient to lose more weight after the surgery and saves the patient from the cost of a second surgery. The most common problem here is that the patient regains the lost weight within 1-2 years after obesity surgery. The risk of a second surgery is therefore critical and must be avoided. Gastric sleeve surgery cost in Turkey differs from hospital to hospital and surgeon to surgeon.
Obesity is the excessive accumulation of fat in the body, which can cause health problems and restrict movements. In Turkey, there are many hospitals and top gastric sleeve centers that offer treatment for obesity. Gastric sleeve surgery is the most commonly used method, where the surgeon removes approximately 80% of the stomach laparoscopically, reducing the patient's appetite and helping them lose weight. Reputable gastric sleeve surgeons in Turkey help their patients to lose weight quickly, while at the same time taking the necessary nutrients and providing them with a healthy diet. Prior to surgery, patients need to follow a strict diet and avoid certain foods to prepare their bodies. Postoperative, patients follow a strict follow-up schedule with their doctors to monitor progress and ensure good health. Possible side effects include digestive disorders like reflux disease, indigestion, food intolerance, nausea, and vomiting, but these are often temporary and can be managed with medication.
A detailed health assessment is made about the patient's medical and surgical history, and then it is checked whether the patient is suitable for the operation.
If the patient needs to take any medication, he/she should share it with his surgeon.
Necessary medical tests such as blood analysis are performed.
The patient is prescribed a sugar-free, low-carbohydrate, increased protein, increased vegetable and plenty of fluid diet 2 weeks before the surgery.
2 days before the operation, the patient is provided to consume plenty of fluids and only protein-consumed foods.
Food should not be eaten 12 hours before the operation and products harmful to health should be avoided.
One of the situations that should not be forgotten is that the more weight the person loses before the surgery, the more weight they will lose in direct proportion after the surgery. Another purpose of this situation is to prevent the person from gaining weight by returning to his old habits. In addition, the lower the patient's weight before the operation, the lower the risk of complications. The faster a good diet and eating habits are established, the more successful the weight loss processes will be.
Postoperatively, patients follow a strict follow-up schedule with their doctors for 3, 6 and 12 months. Obesity patients undergoing gastric sleeve surgery in Istanbul Turkey seem to make more progress in the treatment of diabetes, sleep apnea, asthma, high blood pressure (hypertension) and cholesterol problems. Gastric sleeve surgery has important benefits for joint health as well as getting rid of excess weight. With each weight lost, the pressure on the knee decreases. Therefore, mobility improves and knee pain decreases. In cancer researches involving 88 thousand people, the risks of colon cancer, breast cancer and pancreatic cancer are 33% less in patients who have undergone gastric sleeve surgery.
Digestive disorders that may occur after surgery; Reflux disease, indigestion, significant food intolerance, nausea and vomiting can be seen in patients. After safe gastric sleeve surgery in Istanbul Turkey 1 out of every 5 patients experience reflux disease in the first 12 months, but the good thing is that the problem is temporary. After 3 years, the probability of patients experiencing reflux problem is 3%.
Although a few measures to be taken at home do not completely prevent reflux but they will relieve the patient a lot. These are briefly; eating food at least 3 hours before going to bed or lying down, avoiding foods that increase stomach acid and eating little/often will reduce reflux complaints. If the patient still has reflux and heartburn complaints, he/she should share this with his/her doctor. With the treatment that the doctor deems appropriate, the patient's complaints will be reduced. The best sleeve gastrectomy surgery in Turkey is performed by the most experienced surgeons and the risks are quite low.
The digestive complaints mentioned above can usually be eliminated with diet and behavior.
2 years after gastric sleeve surgery, approximately 1 in 20 patients can gain weight at certain points. This figure increases to 3 out of 4 patients after 6 years. It has been observed that weight gains are much faster in gastric balloon or gastric band applications.
At the end of the 5th year after the operation, an average gastric sleeve surgery patient can regain at least 25% and possibly 50% of the weight they lost. In order to prevent this, the patient should determine a diet and exercise lifestyle.
Diseases such as diabetes and cholesterol, which have been resolved by gastric bypass or gastric sleeve surgery, may recur with weight gain.
With the shrinking stomach after sleeve gastrectomy surgery, patients feel satiated with small foods and liquids in their first year. However, this feeling of satiety may decrease over time and patients may start to eat more food. This results in weight regain. Gastric bypass surgery is more advantageous in this regard because it prevents the absorption of nutrients. Thus, even if the patient consumes some nutrients, he or she cannot get the real nutritional values.
Patients may become distracted from their goals and start to eat more food again, which may cause the patient to expand their stomach.
The most important thing to remember is that sleeve gastrectomy is only a tool. It is necessary to eat the right products and adopt the right lifestyle so that the person does not regain the weight he/she has lost.
In most obese patients, their body skin is biologically stretched to carry high weight fats over long periods of time. Since obesity surgery causes rapid weight loss in most patients, the skin of the person cannot keep up with this change and may cause sagging of the body skin in various regions.
Extra skin sagging can cause embarrassment of one's body. At the same time, this situation can affect daily life. For example;
In some cases, patients manage their skin sagging with various body shaping underwear. In advanced skin sagging, patients find the definitive solution with skin stretching plastic surgery. If the skin sagging is not too severe, it will heal on its own as time passes. The best sleeve gastrectomy surgeons in Turkey support patients with diets that will minimize skin sagging during the weight loss process of the patient after surgery.
Pregnancy after sleeve gastrectomy is much safer and easier for both mother and baby than obese pregnancy.
Things to consider:
It is recommended to wait at least 2 years to get pregnant after gastric sleeve and gastric bypass.
Hormonal changes and infertility after gastric sleeve surgery are usually treatable.
Many bariatric surgery procedures prevent patients' bodies from getting enough vitamins from the foods they need. Therefore, even after waiting 2 full years, it is necessary to ensure that there is no deficiency of vitamins and minerals both before and throughout your pregnancy.
Control of the following vitamins is very important:
The patient should cooperate closely with her doctor, dietitian and obstetrician for the health of both herself and her baby from the beginning of pregnancy.
Before and after each gastric sleeve surgery, the patient should be given the necessary financial and moral support by his/her family and close friends. A lack of self-confidence can be seen in people who cannot lose weight with various non-surgical methods. In addition, food addiction negatively affects a person's lifestyle and psychology. Bariatric surgery is a tool, not a goal. The person may need the necessary psychological support to get rid of old habits and adopt a brand new nutrition-exercise discipline.
Among the positive results of extreme weight loss, a person looks and feels better physically. The person will now have a more attractive appearance physically.
In addition, it will be much healthier for patients considering this surgery to get the opinions of people who have had bariatric surgery before.
If we talk about the recovery process after gastric sleeve surgery, it can be said that it is generally as follows:
Although the pain that the patient will feel is not very severe, it can be managed with painkillers prescribed by the surgeon. Gastric sleeve surgery has the same pain as other laparoscopic surgeries.
Diet: It includes a slow conversion from clear liquids to solid foods and is fed under the control of a doctor.
Activity: Slow return to regular activities and exercises prescribed by the patient’s doctor.
Patients can be discharged home as soon as possible as prescribed by the doctor.
Obesity surgeries cause patients to lose up to 80% of their excess weight. As a result of this situation, the physical appearance of individuals changes almost completely. It can be a shocking experience for individuals to regain their former weakness or to be weak for the first time. Situations that many patients express with bewilderment;
After bariatric surgery, patients should be prepared for the positive and negative psychological shock changes that come with a high amount of dramatic weight loss.
Although under the control of a doctor, the exercises are spread over 2-4 days as 2.5 hours a week;
Exercises are as important as diets for long-term success in gastric sleeve surgery. Patients who exercise regularly after surgery will lose more weight. Studies have shown that patients who exercise obesity surgery have been more successful in losing weight, with differences of up to 10%. 10% difference may seem like an insignificant difference, but it is a very good improvement.
Regular exercises will not only help the patient lose weight faster after the surgery, but will also help him regain his health faster. The activities we refer to as Work-Outs will provide the necessary energy and motivation so that the patient does not deviate from his goal in the fight against obesity.
2.5 hours of exercise per week can be spread over 2 to 4 days, so that the patient can gain habit and endurance.
The patient should have 3 main goals for gaining an exercise routine;
After gastric sleeve surgery, 80% of patients experience vitamin and mineral deficiencies in general. As a result of the diet, some vitamins and minerals may be deficient. The importance of vitamins and minerals in healthy weight loss is much higher than it is thought. Body activities that vitamins affect and regulate in general;
Obesity surgeries should close the vitamin and mineral absorption deficiency caused by various reasons in close cooperation with the patient's doctor and dietitian.
Vegetables and fruits; It is the best way to get the vitamins and minerals that the body needs. For example, broccoli; It is one of the most important vegetables with its richness of vitamins and minerals (vitamins A, C, K and Folate).
Calcium, iodine, sodium, magnesium, iron and potassium are among the most needed minerals in the body. Calcium, which plays an important role in bone health in particular, plays an important role in the immune system together with vitamin D. Long-term calcium deficiency can cause osteoporosis.
If the patient has a sensitivity to certain foods, the necessary supplements are prescribed to the patient by the dietitian or doctor as an additional supplement.
The best gastric sleeve centers in Turkey are trying to apply the right treatment method from the beginning to avoid revision surgery. In the first 7 years after gatric sleeve surgery, 19.9% of patients who had this surgery undergo a revision surgery. The 2 most common reasons for reoperation are weight regain and not enough weight loss.
The average weight loss after gastric sleeve is as follows:
If the patient's post-operative gastric sleeve is far from these averages, he/she should meet with his/her surgeon again and share his complaints about this issue.
Slow weight loss after surgery is usually due to a poor diet and lifestyle. The patient's doctor should provide the necessary support in terms of diet, lifestyle and psychological. The sooner the patient starts the necessary diet, the sooner he/she will put his/her life in order.
The reason why bariatric surgery patients lose less weight may be related to the surgeon's failure to conclude the surgery properly, although it is really rare. Surgeon errors that do not cause sufficient weight loss after gastric sleeve are as follows:
Gastric sleeve surgery gives results by reducing the amount of hormones secreted by the stomach, which causes hunger and makes the patient feel full more quickly while eating. The above surgeon mistakes can reduce or prevent the effects of either or both.
Revision for weight gain;
After the surgery, at least 3 out of 10 patients face the problem of gaining weight again. This amount may be low, or it may be seen that the patient regains all the weight they lost. Generally, weight regain starts from the 18th month, but can be up to the first 6 years, and as a result:
Gastric enlargement as a result of overeating is the most common reason for patients to regain weight after bariatric surgeries.
Post-surgical weight gain varies from person to person and only a very small percentage of patients regain all the weight they lost.
When a person is unable to lose weight naturally, he or she may consider having this surgery by contacting a doctor.
The main purpose of gastric sleeve surgery is to provide weight loss for obesity patients who have not been successful with non-surgical weight loss methods. It also contributes to the treatment of other obesity-related diseases.
Since the patient will lose up to 80% of his/her stomach after the operation, the amount of food he/she takes will decrease significantly and the patient will start to lose weight rapidly in parallel. In addition, since the secretion of the appetite hormone ghrelin will decrease, the patient will have an appetite.
People between the ages of 18 and 65 and with a body mass index over 35 are suitable for gastric sleeve surgery. However, doctors make the final decision whether the patient is suitable for surgery or not.
Gastric sleeve patients return to their normal routine life within 1-2 weeks on average after surgery. If we include the pre-operative period, all processes are completed in 4-6 weeks and full recovery is achieved.
If the patient has uncontrolled diabete and/or gastric hernia and/or severe esophageal inflammation due to reflux is detected in the endoscopy, it is more appropriate to perform gastric bypass for these patients. If there is no problem in the examination and endoscopy of the patient, gastric sleeve surgery can be applied.
Gastric sleeve surgery and other obesity surgeries can not be applied to people who are inconvenient to take anaesthesia, patients with serious psychological disorders, alcohol and drug addicts, and patients with serious heart diseases such as severe heart failure.
Since it is performed laparoscopically, the risks are less. It is more effective and permanent weight loss than other methods such as gastric balloon. The patient can return to his normal life within 1-2 weeks.
As in other open surgeries, there are anesthesia risks that apply to every patient. The mortality rate in gastric sleeve surgery is 0.03%. However, one of the points that should not be overlooked is that there are risks of death in every surgery. Although it is very low, there is also a risk of leakage. Although the risk of hernia can be seen in 1 out of every 10 patients, these patients may need a secondary laparoscopic gastric surgery. Laparoscopic surgery significantly reduces the risk of gastric hernia.
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Prof. Dr. Hasan Altun was born in 1972 in Jülich, Germany and completed his primary, secondary and high school education in Kozlu, Zonguldak.
Prof. Dr. Hasan Altun started his medical education at Hacettepe University Faculty of Medicine in 1989.
He started his general surgery specialization at Hacettepe University, Department of General Surgery immediately after his graduation in 1996, and completed his specialization in 2002 and became a General Surgery Specialist.
After receiving his specialty in 2002, Prof. Dr. Hasan Altun, who worked as a general surgery specialist in state hospitals in Ankara and Istanbul, took part in the organ transplantation team, received advanced laparoscopic surgery training in France and the USA, and worked as the Education and Administrative Supervisor (clinical chief) of the General Surgery Clinic at Fatih Sultan Mehmet Training and Research Hospital in Istanbul.
He received training and gained experience in obesity and metabolic surgery, advanced laparoscopic surgery, robotic surgery and gastrointestinal surgery from the world's leading institutions.
In 2015, he is the first Bariatric Surgeon of Excellence Certificate in the field of Obesity and Metabolic Surgery in Turkey.
He is one of the first physicians in our country to successfully perform surgeries in the field of Advanced Laparoscopic Surgery and Obesity and Metabolic Surgery.
He is one of the first members of the leading international Obesity and Metabolic Surgery Associations in our country.
He has published numerous articles and studies with the highest number of patients and follow-up in the field of Obesity and Metabolic Surgery in the leading reputable journals and scientific organizations in our country and in the world.
He has given numerous trainings, seminars and symposiums to his colleagues in the field of Obesity and Metabolic Surgery in Turkey and abroad and has led the spread of obesity surgery in many countries in our country and in the world.
Prof. Dr. Hasan Altun, with more than 24 years of experience in general surgery around 5000 and successful bariatric surgery around 2000, has operated on Turkey's leading names and has made gastric sleeve and bariatric surgery more popular and less feared surgery.
Inter Bariatrics Clinic serves its patients not only in the field of obesity surgery, but also in advanced laparoscopic surgeries such as gastric hernia, gastric reflux, esophageal surgery, achalasia surgery.
Prof. Dr. Hasan ALTUN is fluent in English. He is married and has 2 children.