General Surgery

Obesity Surgery
by Prof. Mahir Özmen, 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. Mahir Özmen, 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. Mahir Özmen, M.D.

General Surgery
  • Medical School, Ankara University – Turkey
  • General Surgery, Ankara University- Turkey
  • Master of Surgery, Southampton University – England
  • Hacettepe University -Turkey
  • Professor since 2010
  • Sub-specialty on Surgical Oncology 2012
  • Works in İstanbul and Ankara
  • Liv Hospital Group

Prof. Mahir Özmen is one of the highly acknowledged bariatric surgeons of Turkey alongside his academic accomplishments that makes him a recognized international surgeon. He has published over 200 research papers with 4000 citations that carry himself to a very high H-index which is an international measure of academic performance.

He holds many international titles including the American Society of Metabolic and Bariatric Surgery (ASBMS), Fellow of Royal College of Surgeons Glasgow FRCSİ, Fellow of European Board of Surgery FEBS, etc. and acts as an international teaching and governing surgeon who trains surgeons from all around the world.

He prefers to classify bariatric and metabolic surgery in 3 branches as Sleeve Gastrectomy, Gastric By-Pass, and Gastric Duodenal Switch.  He explains Sleeve Gastrectomy as a restrictive procedure that requires 70 to 75% of the stomach to be removed including the fundus that is responsible for ghrelin secretion which is the hormone that controls the appetite. In the 2nd branch of operations, he decides in between Mini Gastric Bypass and Roux-en-Y techniques according to the patient but prefers mini-gastric bypass as long as the situation of the patient permits because it is well tolerated. He explains the major differences between these methods in his video.

Prof. Özmen emphasizes the complexity of the 3rd branch of operations which is the combined procedure that is performed for patients with BMI over 50 or patients with uncontrolled diabetes type2. In his approach, he prefers a single anastomose duodenal switch proximal and clarifies the rationale as having a less bad odor and malnutrition in comparison to other techniques.

“Yes, the number of cases of the surgeon who perform the procedure is very important but it is not everything”

Although he has performed a huge number of cases in bariatric surgery, Prof. Mahir Özmen prefers to emphasize the importance of “being complete” rather than being “only a technician”, underlying reading, writing, and strengthening the academic side.

“You need Best Surgeon, very well-equipped hospital, a talented and well-educated team of surgery in order to overcome any complications”

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