Obesity surgery in Turkey: regain your health and fitness

Dr. Çağatay Demirci, General Surgeon at Kemer Public Hospital, part of the Antalya Public Hospitals Union in Turkey, discusses modern treatment solutions for obesity.

In recent years, the most challenging health problem we face seems to have become obesity rather than cancer, and the problem has become global. In response, governments and healthcare providers, both in the public and private sectors, have started to promote preventative services to tackle obesity. Predisposing factors such as bad eating habits, sedentary lifestyles and some individual health characteristics all play a part in the development of obesity. Where preventative healthcare services are not enough to stop weight gain and its associated problems, bariatric surgery is an effective solution.

Bariatric surgical procedures are designed to restrict the amount of food that the stomach holds resulting in limited absorption of nutrients and calories (malabsorption) or a combination of both reduced gastric capacity and malabsorption. Bariatric procedures also often cause changes to certain hormones, such as ghrelin, also known as the ‘hunger hormone’.

Most weight loss surgeries today are performed by using minimally invasive laparoscopic surgery (keyhole surgery). The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch. Each surgery has its own advantages and disadvantages.

At Kemer Public Hospital in Turkey, the preference is to perform sleeve gastrectomy for selected patients. The Laparoscopic Sleeve Gastrectomy – often called the sleeve – is performed by removing approximately 80 percent of the stomach. The remaining stomach is formed into a tubular pouch that resembles a banana. This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to reduce significantly the amount of food (and thus calories) that can be ingested.  A greater effect of the surgery, however, may come from the changes to the gut hormones that affect hunger, satiety and blood sugar levels.

Short-term studies show that the sleeve is as effective as the Roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also some evidence that the effect on diabetes mellitus risk is similar for sleeve gastrectomy and gastric bypass. The complication rates of the sleeve fall between those of the adjustable gastric band and the Roux-en-y gastric bypass.

Advantages of sleeve gastrectomy

• Restricts the amount of food the stomach can hold
• Induces rapid and significant weight loss that comparative studies find similar to that of the Roux-en-Y gastric bypass. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with maintenance of >50%
• Requires no insertion of foreign objects (AGB), and no bypass or re-routing of the food stream (RYGB)
• Involves a relatively short hospital stay of approximately 2-5 days
• Causes favourable changes in gut hormones that suppress hunger, reduce appetite and improve satiety

Disadvantages of sleeve gastrectomy

• Is a non-reversible procedure
• Has the potential for long-term vitamin deficiencies

Author profile

Dr. Çağatay Demirci is General Surgeon at Kemer Public Hospital in Turkey, a brand new facility that offers an extensive range of modern hospital services to overseas patients. The hospital is part of Antalya Public Hospitals Union, a union of one training and research hospital, 13 state hospitals and 3 dental centres that provides high quality healthcare at fair and reasonable prices regulated by the Turkish Government.