General Surgery

Obesity Surgery
by Prof. Koray Topgül, M.D.

Obesity surgery refers to a group of surgeries that target obesity and/or metabolic diseases, especially type2 diabetes. For treatment of diabetes it is also known as Metabolic Surgery.

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Prof. Koray Topgül, M.D.

General Surgery

Metabolic syndrome is a group of disorders of metabolism that tend to occur together and is caused by obesity, physical inactivity, increasing age and genetics. Metabolic syndrome greatly increases your risk of developing elevated blood sugar (diabetes), elevated blood pressure (hypertension), elevated blood cholesterol and lipids (dyslipidemia) leading to heart disease and stroke.

Diabetes is a medical condition in which the blood glucose levels remain persistently higher than normal. Obesity is one of the most important factors in the development of diabetes.

For Who?

Obesity surgery should be considered for obese who have BMI (Body Mass Index) higher than 35 and all poorly controlled diabetics, especially those who are overweight or obese. Diabetic patients who do not want to take lifelong medication and prefer a surgical procedure to reverse diabetes should also consider metabolic surgery.

Procedures

Most common operations are Sleeve Gastrectomy and Gastric Bypass. These are generally minimally invasive procedures.

• Sleeve gastrectomy

This is a keyhole surgical procedure that coverts the stomach into a long narrow tube about the shape of a banana. This limits the amount of food the patient can eat since your stomach will hold only about a very low percentage of what it did before. This change enhances the effect of intestinal hormones to bring down blood sugar.

Some patients may have concerns about side effects of this size change, however there is no fear of mal-absorption or a nutritional deficiency since the small intestine is not by-passed or re-routed. Digestion occurs normally as the digestive system is not affected by the surgery.

• Gastric bypass

This is also a keyhole surgical procedure which creates a small egg-shaped pouch in the upper stomach that is then connected to the lower part of the small intestine in a “Y” configuration. Food is diverted by this bypass and is only absorbed in a short segment of the intestines.

 

Surgery & Recovery

Surgery is performed under general anesthesia and takes about 2-3 hours. You will be put on a liquid diet for a few days for better progressing towards soft foods. Most patients will stay in hospital for 3 to 5 days. You will be mobilizing the day after surgery and the majority of patients will be back to normal activities and exercise after about 2 weeks.

Before you leave the hospital, the surgical staff will provide you with detailed instructions on how your eating plan should change and how and when to resume certain physical activities. Following your diet will be very important for the long-term success and benefits you will receive by the surgery.

Results

Surgeries result in sustainable weight loss for obese people who have not achieved long term success with other weight loss attempts. With a general consensus of a safe and effective alternative to weight loss management, the outcomes directly reflect on physical and mental wellbeing also.  

Prof. Koray Topgül, M.D.

General Surgery
  • Medical School, Akdeniz University – Turkey
  • General Surgery, Ankara Training and Research Hospital – Turkey
  • Professor title from Altınbaş University – Turkey
  • Sub-specialty on Surgical Oncology
  • Works in İstanbul
  • ASM Anadolu Sağlık Merkezi Hospital

He focuses on oncology surgery for the last 20 years of his professional life, especially on gastrointestinal system cancers. Since “gastrectomy” was originally a cancer surgery procedure and in parallel to the rise of obesity disease, sleeve gastrectomy happened to be performed as a type of bariatric surgery, Prof. Topgül naturally added bariatric surgery into his practice. Today he performs sleeve gastrectomy, gastric bypass, and metabolic surgery according to the condition of his patients.

He draws attention to obesity during childhood or adolescence. 75% of people who are “obese” in this period are also “obese” in adult ages and some become “morbidly obese”. Therefore, a child or adolescent carries his/her disease to adult ages with its co-morbid (accompanying) diseases. He underlines that the first choice should definitely be conservative & non-surgical treatment alternatives unless strict medical and social prerequisite conditions are evaluated carefully. He adds that as long as this discipline is preserved, researches have shown that surgical treatment is successful in the treatment of morbid obesity during childhood or adolescence.

Prof. Topgül points to Turkey as a leading destination for health tourists because of the well-trained human resources and highly technological infrastructure that we have. In addition to that geographical location of Turkey creates advantages in terms of proximity and climate.

While selecting your physician he says, patients should take 2 points into consideration: First the experience of the physician in that particular treatment, and second, the facilities of the hospital and the broadness of existing medical branches in that hospital.

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