Metabolic Surgery

Ileal Interposition surgery is not an obesity operation as an exit point. It is an operation aimed at treating all the health problems within the scope of Metabolic Syndrome, especially treating Type 2 Diabetes. The definition of the metabolic syndrome includes Type 2 Diabetes, hypertension, elevated cholesterol and triglycerides, and excess weight. Therefore, obesity is not among the criteria for Ileal Intervention surgery. However, Ileal Intervention surgery is also aims at the treatment of obesity and morbid obesity, which are caused by severe disabilities such as Gastric Bypass, Duodenal Switch.

The term Ileal Interposition is, in its most abstract form, the process of displacing the initial and final parts of the small intestine. The insulin resistance hormones, Ghrelin (stomach), GIP (duodenum) and glucagon (pancreas), are excreted from the initial parts of the digestive system and the insulin sensitivity hormone, called GLP-1, is released from the L cells in the last part of the intestine. GLP-1 is a hormone that increases the effects of insulin and stimulates insulin production by the pancreas. Basically, the goal of this procedure is to leave the resistance hormones aside and increase the sensitivity hormones. The final part of the intestine is called the Ileum. Displacing the last part of the small bowel (ileum) surgically is called ‘Ileal Interposition’. Not only the last part of the intestine displaced by this surgery, but also a part of the stomach is removed, in order to create other hormonal changes in a manner that strengthens the effect of the Ileal Interposition surgery. Ghrelin hormone levels, excreted from the upper left part of the stomach, are diminished by removal of this part of the stomach.

These operations prevent the passage of food from a very long small intestine. After these surgeries patients have severe fat and carbohydrate absorption restriction. These effects provide strong weight loss and patients can maintain long-term weight loss. However, after these surgeries, very important vital vitamins and minerals those are absorbed in the gut by melting in fat, along with the fat that is severely restricted in absorption, cannot be absorbed. Shortly after surgery, vitamin and mineral deficiencies begin to develop rapidly in these patients. The essential vitamins and minerals can be supplemented with medicines given to patients.

Ileal Interposition does not impair the absorption restriction or absorption. Patients with Ileal Intervention surgery will go into liquid food on the 3rd postoperative day. Within six months to one year they can live without taking vitamins or mineral supplements with a completely free diet. Patients eligible for surgery generally discontinue all diabetes, blood pressure and cholesterol medications they used before Ileal Intervention surgery. They are observed in terms of the course of these diseases during the hospitalization period after the operation. The vast majority of patients are discharged without using any of these drugs. In some of them, the medications are continued in decreasing doses with few and controlled doses ranging from a few weeks to several months until the metabolic effect is expected to settle. When the measurements are reduced to normal, all of these drugs are discontinued.

We would be happy if we can give you a first overview. This page is for informational purposes only. Our consultants will be happy to provide you further information. Your satisfaction is our most important concern.

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