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UrologyEnez HealthNo Comments

Artifical Bladder Protects Social Life

Urinary bladder tumors and bladder cancer, the fourth most common type of cancer in men, are malign tumors originating from the tissues of bladder wall. Its symptoms include frequent urination, sense of burning while urinating, bleeding, incontinence and sudden urge to urinate. In some types of bladder cancer, only treatment is the removal of the bladder. If the bladder should be removed, patients usually delay that surgery and the reason is the necessity of urinary bag use. However, if they know that urinary bag will not be necessary, then they decide for surgery earlier, increasing the likelihood of full recovery. Artificial bladder formed by reshaping the intestines is a method that allows patients to urinate normally and have a more comfortable life. The most important advantage is that this a socially acceptable method that does not lower quality of life. Prof. Dr. Karadeniz explained the treatment of bladder cancer.

What are the causes of bladder cancer?

Bladder is a sphere-like organ that sores the urine coming from both kidneys through urinary tracts (urethra). Malign tumors originating from the inner side of this organ is called bladder cancer. Bladder cancer is more common in men than women. Smoking and chemical substance exposure observed in some factories are among its known causes.

What are the symptoms?

The most important symptom is blood and clots in the urine without pain. In addition, depending on the type of the cancer, complaints like persistent pain during urination and sense of burning towards the end of urination are also reported. This bleeding may not be visible sometimes, but it will be detected in the urine analysis.

How is it diagnosed?

Usually, a mass in the bladder can be easily diagnosed with abdominal or urinary system ultrasonography, and upper and lower Computed Tomography with contrast agent can be used
for diagnosis as well. However, when these examinations are unable to provide a definitive diagnosis, that a method involving the insertion of a camera system through urinary meatus in order to visualize inside the bladder can be used. After diagnosis, Closed TUR Tm (Trans Urethral Resection Tm) operation is performed with an endoscopic camera.

How is TUR Tm performed?

Operation can be performed under general or local anesthesia. Bladder is accessed through urinary meatus and the cancerous section is completely removed and samples are collected from all layers of the bladder by using a special electrical device. The patient can stand up the next day, urinary catheter is generally removed on second or third day and the patient can be discharged.

When is radical cystectomy required?

In this operation; bladder, prostate, portion of the lower urinary tract, seminal vesicles, and lymph nodes around the major surrounding vessels are removed. It takes for 6-8 when performed fully, patient is taken to intensive care for at least 24 hours if needed, and then transferred to the ward. Patients can return home 10-14 days after the operation.

Why the removal of lymph nodes and its number is important?

This is probably the most important part of radical cystectomy operation. Removal of lymph nodes requires special training and experience. However, the more lymph nodes removed the longer the life expectancy of the patient. And in case of cancer in lymphatic tissues, than the actual progression of the disease can be determined for proper planning of additional chemotherapy.

How do patients urinate after the bladder is removed?

The most frequent method is called “ileal conduit”. Both urinary tracts (urethra) are connected to one end of 12-15 cm portion of small intestines and the other end of the intestines is attached to outer abdominal wall. Urine coming to this intestine part via urethra fills into a bag adhered to the skin and the bag is drained by the patients. The urinary bag should be replaced in every 2-3 days. This is artificial bladder (neobladder) method called “orthopedic bladder” which is an important alternative to the old method.

What are the advantages of forming a bladder with intestines?

If the removal of bladder is required, it is not easy for patients to make the decision and such delay negatively impact their life. The most important advantage of artificial bladder (neobladder) is that “it does not lower quality of life” and
it is “socially acceptable”. This operation is performed to allow patients to urinate normally in order for them to have a more comfortable life. A portion of the small intestines is reshaped into a sphere and both urinary tracts coming from the kidney are attached to this; one end of this new bladder is then connected to the urinary tract inside the penis. 15-18 days after the operation, the urinary catheter is removed and patients are trained to urinate with their new bladder. Learning to urinate usually takes 4-5 days, and at the end of this period patients become able to fully empty their bladder.

Interventional RadiologyEnez HealthNo Comments

Scalpel-Free Treatment for Brain Aneurysms

Protruding, bubble-like formations in the brain vessels are called aneurysm and has high death and disability risk if ruptured. Therefore, detected aneurysms must be treated. Today, thanks to advanced medical technologies, aneurysms can be treated by inserting a catheter from the groin area, without scalpel and open surgery. Neuroradiology Specialist Prof. Dr. Minareci explains aneurysm and current treatment method.

People with aneurysm in their family history are at high risk

Aneurysm, ballooning of a weakened blood vessel in the brain, may remain without causing any complaints, however, can cause death or serious paralysis if ruptured suddenly. Therefore, aneurysm must be treated immediately after diagnosis. People with cerebrovascular disease history in their family, aneurysm in a close relative or patients with high blood pressure are at even higher risk. The bleeding risk of an aneurysm is higher in smoking patients than non-smokers.

Only a catheter insertion from the groin

Previously, aneurysm treatment was limited to open brain surgery. In recent years, with the advanced methods in medicine, aneurysm treatment is possible without open surgery; a catheter is inserted from the groin area and guided up to the affected vessel. The duration required for this treatment is significantly less than open surgery and patients can return their normal daily lives within a few days. This treatment method, called embolization, is performed by using state-of-the-art imaging devices and highly specialized materials. The physician must be specially trained (interventional neuroradiology) and experienced in order for a successful treatment.

Medical OncologyEnez HealthNo Comments

Recommendations for Fatigue During Cancer Treatment

Fatigue of cancer treatment may last long

Fatigue can be seen as a result of anemia, endocrine changes (changed operation of glands), and respiratory distress that are induced by cancer, and can also be seen in advanced cancer patients receiving cancer treatment. Cancer treatment-related fatigue is seen in 14-96 percent of patients receiving cancer treatment and 19-82 percent in post-treatment patients. Just like pain, fatigue is also associated with personal perception. Patients can describe “fatigue” as exhaustion, laziness, pain, lack of energy, consumed, weary. Fatigue related to cancer treatment is different than the fatigue experienced by healthy individuals during their daily life. Healthy fatigue is a sudden fatigue that resolves with sleep and rest. However, cancer treatment-related fatigue is classified as chronic fatigue as it lasts long, not completely resolves with sleep and rest, and it adversely affects body functions. All functions are negatively affected by fatigue: mood, physical functions, work performance, social relations, family care, cognitive performance, school study etc. The form of cancer treatment-related fatigue varies based on treatment schedule and type. For example, patients who receive frequent (two or three times a week regularly) experience peak fatigue in the days following the treatment, and they feel less fatigue until the next treatment. But fatigue increases with the treatment in radiotherapy.

Recommendations of cancer treatment related fatigue

  • Rest but not too much: Plan our day and take short breaks (30 minutes or less). Have 7-8 hours of night sleep. Consult your doctor if you have any problems with sleeping.
  • Be as active as you can: Regularly exercise at a moderate intensity, and walk. Especially walking has been proved to be the best way to beat fatigue.
  • Plan your daily tasks: Keep a journal where you record how you feel each day. Your doctor or nurse will ask you to evaluate your fatigue with a 0-10 scale and ask the type and what makes this pain good or bod. Keeping records about these questions will make it easier to answer.
  • Reserve your energy: Determine your priorities and plan accordingly. Spread your activities throughout the day and take breaks. Do not engage in activities that require you to stand for long periods of time. Hot showers and baths consume your energy when they last long.
  • Ask for help: Ask for help from your family members and friends. Domestic work, preparing food, running errands… Do not force yourself to do more than you could.
  • Get support: Join a support group. Sharing your feelings with others may decrease the burden of fatigue. You can consult your doctor or nurses or related institutes and persons to reach a support group.
  • Have good nutrition: Drink plenty of water and fruit juice. Eat as good and healthy foods as you can cook. Try to eat at least 2.5 bowls of fruit and vegetables every day. Intake sufficient protein and calorie for your health.
  • Call your doctor: Call your doctor if you feel too weak to get out of the bed, feel disoriented, lose your balance or fall, feel dizzy, experience problems with waking up or if your fatigue gets worse.
  • It will take time for you to feel like your old self, however, if you can achieve to stay active, you can restore your energy quicker.
HematologyEnez HealthNo Comments

Don’t be Afraid of Lymphoma Cancer!

Lymphoma, known as lymph cancer in the general public, is a cancer of the lymph nodes. It manifests by enlarged lymph nodes. Lymph nodes are not palpable and their growth is unnoticeable in the absence of a harmful stimulant in the body. Lymph nodes form a system that surrounds neck, arm pits, groin and vessels. Hematology Specialist Prof. Dr. Yenerel said ‘’40 years ago only 40% of the patients survived with lymphoma treatment, however, this rate is well above 85% today’’.

‘’Wait- watch strategy’’

Highlighting that lymphoma has 30 sub-types, Prof. Dr. Yenerel states that, in some cases, lymphoma is only followed-up without any necessity for treatment. Prof. Dr. Yenerel said “Disease progresses rapidly for cases. 40 years ago, approximately 40% of the patients survived with lymphoma treatment, today our we can have very successful results in 85%, even 100% of the cases”. In addition to lymph nodes, lymphoma can also be seen in tonsils, spleen, liver and intestines. Lymphoma can have slow, moderate and rapid progression, and it is classified based on disease progression rate. Lymphoma types with rapid progression can manifest with lymph node growth, as well as sweating, weight loss, fever and fatigue. Slow progressing lymphoma types can be closely monitored with a “wait and watch strategy” for years until the lymph nodes cause compression on organs.

Highly successful results with lymphoma treatments

Although the main cause is not clear, lymphoma is known to be affected by contact with pesticides, radiation and environmental conditions, and also has a direct relation with AIDS. However, today, lymphoma treatment can provide extremely successful results. Lymphoma is no longer a terrifying disease thanks to early diagnosis and personal treatment methods. Target-oriented smart drug therapies gradually increases the recovery rates.

RadiologyEnez HealthNo Comments

Ablation, Freezing and Electric Treatment for Cancer

Cancer is the second most common cause of death in developed countries and there are many modern treatment methods available. Most of the cancer patients are afraid of surgery as much as fear the cancer itself. Image-guided treatment is one of the most important steps of cancer treatment; it provides valuable advantages in terms of patient comfort while destroying the cancerous cells in the most effective way. Liver, kidney, lung and some bone tumors are treated through destruction with ablation method. Radiology Clinic, Interventional Radiologist Prof. Dr. Ucar explained.
For liver, kidney, lung, soft tissue and some bone tumors, in patients who are ineligible for surgery or cannot be operated, the tumor area can be treated by heating, freezing or electrical current without surgical incision. Patients can be discharged one day after the procedure and return their normal life in a few days.

Which specialists decide interventional treatment?

All these treatments are decided by multidisciplinary approach with not only the interventional radiology specialist, but also with a group of doctors who diagnose and regulate the treatment such as medical oncologist radiation oncologist, general surgeon, nuclear medicine specialist, urologist, chest diseases and gastroentrology specialists.

What methods are used?

These methods can be classified in two: ablation and embolization. Ablation methods include radiofrequency, cryo, microwaves and electroporation. By using digital image-guided tomography or ultrasonography, special needles are placed inside the tumor tissue. Tumor tissue is completely destroyed by heating (in radiofrequency and microwave techniques) or by freezing (in cryoablation technique). And in electroporation procedure, a recent method, electrical current is applied to the tumor by using needles. Electrical current damages the tumor tissue by destroying the cell membranes. This treatment is especially used for cancers that are adjacent to vital tissues. The tumor can be completely destroyed while preserving the vessels, bile ducts and urinary canals. These ablation methods are performed in major cancer centers in the USA and provide similar results with surgical operations in tumors less than 5 cm in diameter.
There are embolization methods that extend the life expectancy and quality of life of liver cancer patients who are not eligible for surgery. Embolization is the process of slowing or stopping the tumor growth by occluding the vessels that feed the tumor. This method can be combined with chemotherapy drugs and its efficiency can be increased. In addition, life expectancy can be increased by combining with locally irradiating atoms in patients who are not responsive to chemotherapy. This method is very well tolerated.
It can be performed as ambulatory, without hospitalization.

How is it performed?

In ablation procedure, after local anesthesia and pain drugs are administered, a needle is placed to the tumor location by using tomography or ultrasonography and the tumor is destroyed. Embolization procedure is performed by entering from the pelvic artery in angriography room and finding the portion that feeds the tumor inside the liver artery by using thin tubes. Occluding particles, chemotherapy drugs or locally irradiating atoms are injected.

What should patients expect after the procedure?

The patients are followed up at the hospital for one day. And they can return their daily activities in a few days.

Which patients are eligible for this procedure?

It can be used for liver, kidney, lung, soft tissue and some benign bone tumors (Osteidosteoma etc).

Who are most suitable for the treatment?

Approximately 15-20% of liver cancer patients can be operated. This is due to the fact that the size or number of tumors is too high for surgery, or conditions that prevent surgery such as cirrhosis, lung, heart disease. Ablation methods are used for up to 5 tumors less than 4 cm in diameter, however, larger tumors require embolization methods. Tumor can be destroyed in these treatment or shrinked to a size that is suitable for surgical operation.

What are the advantages of these methods?

  • No anesthesia is used
  • No large surgical incision or wound
  • Short procedure time
  • Patients return their daily life after the procedure
  • No severe pain
  • Lower cost in comparison to conventional surgery
Pain Clinic (Algology)Enez HealthNo Comments

Robotic Era in Hip Prosthesis: Makoplasty

The average lifetime of human is increasing, and so are the diseases. It is mandatory to take precautions against arthritis (calcification) that occur as the people age. As hip joint is one of the main joints that bear the body weight, wear and disruption risks are higher. Stating that hip joint arthritis is more prevalent in women older than 40 years of age, Liv Hospital Orthopedics and Traumatology Specialist Prof. Dr. Erden Erturer explained the conditions for which hip prosthesis is used and the robotic method in hip prosthetics surgery.

How does hip calcification (osteoarthritis) start?

Hip osteoarthritis or coxarthrosis, known by the general population as the calcification of hip joint, is the most common cause of hip pain in middle aged and older people. Arthritis is the inflammation of the joint. There are many disorders that can cause inflammation and deformation in the joints, and these lead to arthritis by causing permanent damage on joint surfaces. Normally, joint cartilage has a smooth and slippery surface. Arthritis causes thinning, roughness, and fractures in the cartilage that extend down into the bones. As the deformation of the cartilage tissue worsens, contact and friction start between the bone surfaces. The joints lose their smoothness and pain occurs.

What are the symptoms of hip osteoarthritis?

The main complaint of arthritis patients is the pain. Initially, pain aggravates with activity and load, and generally decreases after rest. The pain around the hip may spread to femur and groin areas. As the disease progresses, it restricts joint movements and causes difficulties in walking. And pain does not go away even if the patient rests.

 Aside from calcification, what conditions cause hip pain?

The most frequent types of hip pain are caused by soft tissues like muscle and ligaments in this area. Standing for long periods of time, exercises and movements that are not routine can cause muscle pain. Directly bone-related cancers can be seen in the hip region, as well as cancers with different origins can spread to hip bones and cause pain. Nerves in the hip area originate from the back region.   Therefore, conditions like disc herniated and slipped disc can manifest with pain that extends.

Pain Clinic (Algology)Enez HealthNo Comments

Pacemaker Solution for Back Pain

Many people complain about back and neck pain. And there is this group of people, who can never get rid of pain despite having multiple herniated disk surgeries. Stating that spinal cord pain pacemaker can be a solution for these patients, Liv Hospital Algology Specialist Prof. Dr. Kader Keskinbora said “Some patients still suffer from pain despite multiple back and neck surgeries. If pain management methods, physical therapy and medication provides no pain relief, than the treatment method should be the spinal cord stimulation, a spinal cord pacemaker for pain. In this method, an electrode is placed into the spinal cord of the patient and its end is connected to a current generator (pain pacemaker). The current generated by the pacer is conducted to the spinal cord via electrode and prevents the pain signal from being transmitted to the brain. Patients can control their back and neck pains by activating the pacemaker.”

Depression can cause back and neck pain

Spine-related pains are especially felt at lower back as well as neck and back. These pains may start severely in a sudden way (within six weeks) or can continue at a moderate severity for years. Pain in the lower back and neck area can often be due to muscle spasms, calcification of various joints (facet joints) and disc herniation. These pains may start after an activity or trauma or may occur without an apparent cause. Especially the people with mental and emotional strain, weak low back and abdominal muscles due to sedentary work and lifestyle are at higher risk for lower back and neck pain. If the back and neck pain that are persistent or have sudden onset does not decrease after physical therapy or if surgical correction is not necessary, then interventional pain treatment options can be considered. Injection (cortisone) and radiofrequency treatment can be applied for the facet joint that causes back and neck pain or the nerve roots affected by herniation. In recent years, radiofrequency therapy applied to lower back and nck nerve roots has been considered as more effective than injection treatment and provides longer pain treatment and is preferred as it does not cause any tissue damage.

Pacemaker controls the pain

The other important group of patients are those who have undergone multiple back and neck surgeries but still suffer from pain. After lumbar and cervical herniated disk operation, some patients can have severe leg and low back pain due to some adhesions in the spinal canal.  These patients have to undergo multiple lumbar surgeries as the pain does not relieve after herniated disk surgery. Each herniated disk surgery can cause a new adhesion and therefore further increased pain. If pain management methods, physical therapy and medication provides no pain relief, than the treatment method should be the spinal cord stimulation. In this method, which is also called spinal pacemaker, an electrode is placed into the spinal cord of the patient and its end is connected to a current generator (pain pacemaker). The current generated by the pacer is conducted to the spinal cord via electrode and prevents the pain signal from being transmitted to the brain. With this highly effective method, patients can control their back and neck pains by activating the pacemaker.

Orthopedics And TraumatologyEnez HealthNo Comments

Young Women are More Affected by Scoliosis

Although the cause of scoliosis (curvature of the spine) is not fully understood, the strongest theory suggests genetics. It is 10 times more prevalent in young women than men. Highlighting that scoliosis is more common in adolescent girls, Liv Hospital Istanbul Spinal Surger Specialist Prof. Dr. Cagatay Ozturk said “Initially, scoliosis causes aesthetic concern, however, it can compress lungs and intestines in the latter stages. Therefore, early diagnosis is of crucial importance for necessary precautions.” Prof. Dr. Cagatay Ozturk answered questions about scoliosis.

Scoliosis is also seen in people with orthodontic problems

The curvature of the spine must exceed a certain angle in order for scoliosis to be noticed. Otherwise, it might be difficult to observe. Scoliosis of the lower back may not be noticed until 30-35 degrees of curvature. If the child is overweight, by the time scoliosis is initially noticed, the condition could have reached to a surgical stage. If the child is thin and scoliosis is in back region, then the condition can be recognized at an earlier age. Additionally, it is possible to say that scoliosis is more prevalent in patients with orthodontic problems.

Scoliosis can progress despite the bracing

In scoliosis cases up to 25 degrees, patients are more closely monitored during adolescence, where the progression potential of the disease increases. Bracing (corset) treatment can be performed for scoliosis cases up to 35 degrees. Initially, the bracing is used for 23 hours a day and it might be necessary to use bracing for a longer period of time depending on the scoliosis onset age. However, scoliosis has a 60% progression potential despite the bracing.

Scoliosis is not a chronic disease

With the current treatment methods, scoliosis is no longer a chronic disease. Surgical procedures can be performed for scoliosis patients who have more 40 degrees of curvature. Surgery, with timely diagnosis and suitable patient selection, can provide a straight spine without any aesthetic problems and patients can take part in all sports activities (except for professional level) as with their peers and can have children in the future.

Pediatric HematologyEnez HealthNo Comments

Do not Fear Leukemia

Leukemia is a disease that occurs one in every 25,000 children, caused by genetic defects in the blood cell nucleus and manifested by cell immortality and proliferation. However, leukemia is no longer a terrifying disease. It is possible to completely recover from leukemia with early diagnosis and treatment. Liv Hospital Pediatric Hematology-Oncology Specialist Prof. Dr. Hilmi Apak warns parents about sudden and ongoing symptoms, and longer 10 days of fever in their children. Prof. Dr. Hilmi Apak: “Weakness, fatigue, anemia, gingival and nasal bleeding, causeless bruises on the skin without any trauma, excess menstrual bleeding and persistent fever must be noted. These symptoms may indicate leukemia”.

Body cannot defend itself

Generally, leukemia occurs after an infection, as a disease of the immune system. The body becomes unable to defend itself after uncontrolled growth of leukocytes and the disease disturbs the functions of other blood cells like red cells and thrombocytes. When leukemia develops in the patient, red blood cell production in the bone marrow decreases, leading to anemia. Reduced bone marrow causes thrombocytes to decrease. When platelets, which are plate-like cells that protect our body against bleeding, decrease, symptoms such as easy bleeding, bruising and fever may occur.

Beware of the symptoms

Complaints similar to leukemia symptoms can easily be seen in children of any age, so families should observe the symptoms carefully instead of panicking. Every children can have a bleeding nose or bruises on their legs. The important thing to observe is the duration of the complaints. For example, when a child has flu, they may have nasal bleeding for a few days. However, if the bleeding persists, then a doctor must be consulted. In addition, in case a child has persistent fever for more than 10 days, persistent and increased number of bruises, then a doctor should consulted. If an abnormal condition detected, if the liver is enlarged, there is gland formation in the arm pits, neck and groin area, growth in sweat glands and suspicious findings in blood count, then hematology department must be consulted.

Diagnosis and treatment

If there is leukemia suspicion, blood count and microscopic analysis must be performed. In case of a suspicion, then further examination would be performed by taking a bone marrow sample. If leukemia is detected based on the examination in a pathology laboratory, bone marrow will be subject to additional tests to determine the type of leukemia. Cortisone drugs are the main components of the treatment. If an acute leukemia responds well to cortisone treatment, then there is increased chance of high response rate for chemotherapy drugs. In leukemia, patients need to be constantly monitored and supervised by a physician, as their immune system is weakened and blood transfusion need is present. Treatment may last two years, including ambulatory treatment. Patients are closely followed up against recurrence. In case of recurrence, intense chemotherapy is applied and bone marrow transplantation is planned if necessary.

Bone marrow transplantation not a primary preference

Bone marrow transplantation is not a primary preference in leukemia. Bone marrow transplantation is decided based on the cell type in the patient, the response to the treatment and the possibility of recurrence. Initially, chemotherapy is a more effective method than bone marrow transplantation. However, if chemotherapy becomes ineffective later on, then bone marrow transplantation is considered. In bone marrow transplantation, very high doses of chemotherapy, to a point where patient’s bone marrow is completely disappeared, is applied. Then, healthy bone marrow collected from a suitable donor is transplanted to the patient under appropriate conditions. While bone marrow transplants from relatives are generally successful, similar results can also be achieved with bone marrow of other individual outside the familiy.

Obesity SurgeryEnez HealthNo Comments

Rebirth with Obesity Surgery

Upon deciding for the obesity surgery; the heart and circulatory system, lungs, hormones are tested and other general assays are performed. In addition, the patient undergoes psychological evaluation.

When a person loses most of their excess weight after obesity surgery, they don’t just recover physically, but socially as well. They regain their confidence, living the joy of a rebirth. Liv Hospital Obesity Surgery Specialist Prof. Dr. Hasan Altun explained the obesity surgery.

Who are overweight, obese and morbid obese people?

Body mass index is used to decide whether a person is overweight or obese. Body mass index is calculated by dividing the weight by the square of the height. Let’s consider a 100kg and 170cm person; their body mass index would be approximately 35. People with body mass index between 20-35 are defined as overweight, if BMI is over 30 than it is called obese. And a BMI value over 40 is defined as morbid (fatal) obesity.

Is it impossible for morbid obese people to lose weight with sports and diet?

The main goal of the obesity treatment is to enable the person to lose weight by making lifestyle changes. Non-surgical methods (diet, acupuncture, medication, sports etc.) must be the priority.

However, the success rate of these methods in morbid obesity is 10%, at most. There are people who managed to lose weight with these methods, however, generally the problem is weight maintenance.

What is the admission reason of obesity patients; aesthetics or health?

Generally, patients refer to surgery as a last resort. Majority of the patient admitting to the clinic are the ones who tried and failed with many methods. There are patients who come for aesthetic reasons, but they are very few. Most of the time, their concern is health. Unsuccessful drug treatment of the diseases caused by obesity, such as diabetes, hypertension, sleep apnea, high cholesterol is another reason for patients to opt for surgery.

What is the current status of obesity in Turkey?

Based on body mass index numbers published by Turkish Statistical Institute; 25% of women are obese, 29% are overweight, while 15% of men are obese and 38% are overweight. These numbers are close to that of those developed countries.

What other diseases does obesity cause?

There are many common and obesity-related accompanying diseases that significantly reduce quality of life. Diabetes, obesity, sleep apnea, high cholesterol, hypertension, reflux, asthma, joint problems, vascular problems in the legs are some of them.

Can everybody undergo surgery? Who are eligible for obesity surgery?

Not every patient who apply for obesity surgery can be operated. Patients are required to meet certain criteria. They must have tried non-surgical methods for a period of time. Patients must be 18-65 years of age and be able to go under anesthesia. Body mass index must be over 40; or there must be an additional obesity-related disease if BMI is between 35-40, and diabetes or metabolic syndrome if BMI is between 30-35. In addition, there must be no untreated psychiatric disorder and no substance or alcohol addiction.

Do you decide for surgery on your own?

Surgery decision is made by a committee. This committee is consisted of obesity surgeon, endocrinologist, cardiologist, pulmonologist, psychologist or psychiatrist and a dietitian. The surgery decision is made by the evaluation of these experts.

How is surgery performed?

Today, these surgeries are performed with high technology means. Laparoscopic or robotic methods are used to perform the operation through one or multiple holes, instead of opening the abdomen area. Surgeries gradually take less time with the advanced technology. The sleeve gastrectomy, one of the most common obesity surgery, can be completed in 45 minutes.

When do patient return their normal life?

Thanks to technology, these surgeries are performed without opening the abdomen; therefore, patients can return their daily lives within 1 week.

When does weight loss start?

Patients start losing weight right after the surgery; they can lose up to 3-4 kilograms during their 2-3 days hospital stay. The weight loss happens rapidly in the first months and lasts for 1-1.5 years. Patients lose 75-80% of the excess weight. 


Is 100% success possible after the surgery?

Compared to diet and other methods, success rate of these surgeries is very high. Success rate varies between 80-95% depending on the method.

Do patients have difficulty after the surgery? Can they adapt quickly?

The patient adaptation after the surgery is high. Especially the rapid weight loss in the first months increases the adaptation rate. In order to enhance the adaptation, patients are followed up after the surgery. The patient is closely monitored by the surgery team,dietitian and psychologist and necessary actions are taken for patients that have difficulty with adaptation. And periodic group therapies are performed to increase compliance and success.

Is there a risk of failure to lose weight or regain?

If the patients are monitored well, the risk of weight loss failure or weight regain is very low. Depending on the method, this rate is 5-10%, at most.

What is required from the patients after the surgery?

After the surgery, liquid diet is required for 1 month and then the process of transitioning to solid food. Compliance is very important in this period. The patients are required to comply with certain limitations after the surgery and support the weight loss by increasing their physical activity.

What is improved after the surgery? What sort of comfort can patients have?

With weight loss, the patients can get rid of many accompanying diseases caused by obesity. Additionally, they can perform their physical activities more comfortably and become free from many restrictions caused by obesity in their life. Efficiency and success in the business life also increases with weight loss.

People regain their confidence and their psychological problems decrease.

What are the surgical methods performed for obese patients?

Sleeve gastrectomy is the most common obesity surgery. Previously, the most frequent method was vertical banded gastroplasty, also known as stomach stapling. However, it became less common due to low success rates and associated complications. Other methods include gastric bypass that restricts absorption and duodenal switch surgeries.

Why sleeve gastrectomy is the most common method?

Sleeve gastrectomy surgeries are shorter and simpler. They do not restrict or disrupt absorption; there is no intestinal intervention. Therefore, there is no risk of future intestinal problem and no need for lifelong vitamin and mineral supplement. It is the most preferred method for its highly successful outcomes and simple method.

How about gastric bypass?

Gastric bypass is an older method. It has been used for a long time. In addition to restricted food intake, it also disrupts absorption as intestines are shortened. In comparison to sleeve gastrectomy, bypass method provides better weight loss, and higher recovery from obesity-related accompanying diseases. However, surgery duration is longer, more complicated and required lifelong vitamin and mineral supplement. Therefore, gastric bypass is used for a limited patient group.

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