Bariatric Archives - Page 3 of 4 - Turkish Bariatric Surgery

Obesity is among the most common health problems today. So what is obesity?

The World Health Organization (WHO) has defined obesity as excessive fat accumulation in the body to the extent that it impairs health. In other words, it is the situation where the fat mass is excessively increased compared to the lean mass, and it is also a risk factor for acute or chronic disease that occurs as a result of excessive fat accumulation in the body.

Obesity, when untreated, shortens life expectancy and impairs quality of life. For this reason, individuals should maintain their ideal weight and be treated under the leadership of a physician and dietitian.

Bariatric surgery is the name given to all surgical interventions performed to eliminate morbid obesity. However, it should not be the first choice for every patient in the treatment process. First of all, patients should be provided with weight control with diet and exercise.

However, in overweight patients with a very high body mass index, this method may not provide long-term sustainable weight loss. For this reason, bariatric surgery is a treatment method that is increasing day by day in order to provide permanent weight control for some patient groups.Patients diagnosed with obesity should also be evaluated by an endocrinologist, dietitian and, if necessary, a psychologist.

Therefore, centers that work with a multidisciplinary weight management approach for their surgical intervention are important. It is also important that these centers are equipped to meet the care needs of individuals with obesity.

Weight loss surgery is 80% successful. The number one reason why the other 20% fail: not following the post-operative diet.

You must be disciplined and determined to stick to the program. This includes changing eating behaviors and exercise habits. It is very important that you adapt to the program prepared by your dietitian and that you follow up constantly.

The thyroid gland is a butterfly-shaped organ that secretes thyroid hormones (T3, T4) into the body and is located in the midline of the neck in front of and on both sides of the trachea. Hypothyroidism occurs as a result of the gland secreting less hormone, and hyperthyroidism, known as toxic goiter among the people, occurs as a result of excessive secretion. A mass called nodule and associated cancers may develop in it. Apart from these, there are inflammatory diseases called thyroiditis of autoimmune origin (Hashimoto’s thyroiditis, Basedow Graves) or microbial origin.D

Inflammatory and autoimmune diseases are treated with drugs, while toxic goiters that do not respond to treatment, large cancer-suspected nodules and cancer-diagnosed nodules are treated surgically.
The most important reason for the formation of nodules is iodine deficiency in water.
Nodules are basically evaluated with neck ultrasonography and fine needle aspiration biopsy (FNAB).
In the presence of nodules diagnosed as cancer or suspected, surgical treatment should be performed.

Depending on the location and size of the tumor and nodules, patients are performed either bilateral total thyroidectomy or unilateral total thyroidectomy. If the cancer spreads to the lymph nodes in the neck region, neck dissection operations should be performed in order to clean the glands in the neck.

The thyroid gland is an important surgery because of the adjacent vocal nerves and the presence of 4 lentil-sized parathyroid glands that manage bone metabolism. In case of injury to the vocal nerve, permanent hoarseness and shortness of breath develop. In order to prevent these problems, it is necessary to use a monitoring device that shows the nerves as well as a meticulous surgery. Surgical experience is critical at this stage.

Surgical treatment can be done open and closed, namely laparoscopic surgery (TOETVA). In the closed method, thyroid surgery is performed by entering through the mouth. The purpose of this method is not to leave a visible scar on the neck. Today, cosmetic surgeries are preferred by patients.

What awaits patients after goiter surgery?

Patients are definitely prepared for surgery, including thyroid hormone tests. Hormone levels must be normal for surgery. The surgery takes about 2 hours. Nerve monitoring must be done in the surgery. If everything goes well, the patients who are hospitalized for 1 day after the operation are discharged by removing their drains.

After about a week, the pathology result is evaluated.

Patients diagnosed with cancer are referred to Nuclear Medicine centers for Radioactive Iodine therapy (Atom therapy).

Thyroid hormone medication is started and followed-up for those who come clean as a result of pathology.

Parathyroid gland diseases and surgery

They are glands that secrete parathyroid hormone (PTH) as large as 4 lentils, two on the right and two on the left, on the thyroid gland. They regulate the body’s calcium metabolism. It is the hormone that has the most important role in bone formation and destruction.

These glands must be protected during thyroid surgery. In addition, there are adenomas of the parathyroid gland that cause enlargement and excess hormone secretion, and their treatment is surgical. Surgical removal of structures called adenomas provides definitive treatment.

The treatment is done by open surgery or closed laparoscopic method. Removing the correct gland and protecting the nerves is critical in surgery.

Nutritional counseling for patients undergoing bariatric surgery is divided into preoperative and postoperative periods.

By applying a liver reduction diet in the preoperative period, we aim to prepare the patient for the operation, to reduce the risk of complications, and to facilitate the postoperative process by reducing the visceral fat levels and the liver volume.In the postoperative period, the main aim is to ensure that the patients fully comply with the postoperative diet stages, and to reach the ideal weight by preventing macro and micro nutrient deficiencies.

It also accelerates post-operative wound healing, prevents loss of body muscle mass, and prevents problems such as vomiting, diarrhea, reflux, dehydration and dumping syndrome.Studies show that patients who follow a dietitian in the postoperative period are more successful in changing their nutritional behaviors.

This final stage should promote healthy eating for life. Protein intake is important and must be taken in sufficient quantities together with natural foods. It is important that solid and liquid foods are not consumed together at this stage and in the following period, in order not to increase the stomach volume.

In addition, using small plates will help us to provide portion control more easily. It is recommended to introduce new foods that are difficult to tolerate slowly and carefully. Energy need, height, body weight and age are important criteria in determining portion.

It is a surgical operation in which approximately 75-80% of the stomach is removed. After the operation, the stomach shrinks significantly compared to its previous volume, thus causing less food intake.

Since the appetite hormone (Ghrelin) secreted from the stomach (fundus) part removed in this surgery decreases after the operation, the level of this hormone in the blood drops significantly.

Therefore, the feeling of hunger weakens and appetite decreases in patients. In the long term, there is no significant problem in the absorption of nutrients necessary for the body.

Nutrition is very important for the individual who has had Gastric Bypass surgery. It is very important that the patient adheres to the nutrition program meticulously, otherwise the patient may not reach the targeted weight.

The patient should be fed strictly for the first 24 hours with a liquid-focused diet. You can then gradually switch to solid food. When consuming food, it should be chewed well. Meals should be eaten in small amounts and frequently.

The diet should be rich in protein, contain moderate fat. Foods containing simple carbohydrates (such as sugar and sugary foods) and high-fat should not be consumed. Very cold and very hot foods should not be eaten as they trigger rapid transition. One should rest before and after the meal.

Postoperatively, after the patient’s oral intake is opened, it is started within the first 24-48 hours.

The patient’s time to consume the meal should be 15 minutes and the volume to be consumed during this time should be 30 ml.

The aim at this stage is to start bowel movements after the operation and to provide the patient with fluid, electrolytes and a small amount of energy that he or she needs.

During this period, water, powdered protein supplements, freshly squeezed fruit juice outside the citrus group, vegetable juice that will not cause gas, grain-free and sugar-free compote juice, broth and chicken broth are among the foods that can be preferred.

Materials:

1 zucchini
1-2 green onions
1 glass of light milk
1 glass of water
100 g light labneh cheese
Too little salt

Recipe: We chop the green onions. We grate the zucchini. We cook both of them in a pan with very little oil. When the onion and zucchini leave themselves, we add the water. We run it through the blender. Then we add milk and light labneh and pass it through the blender again. When it starts to cook, you can take it from the stove and serve.

Note: In the liquid and puree period, consume by filtering. In the liquid period, you can prefer a more dense consistency in the puree period.

Newer Posts

Older Posts

WHAT IS OBESITY?

WHAT IS OBESITY SURGERY?

WHAT HAPPENS IF I DON’T FOLLOW THE DIET?

THYROID GLAND DISEASES AND SURGERY

What awaits patients after goiter surgery?

Parathyroid gland diseases and surgery

THE ROLE OF THE DIETICIAN IN OBESITY SURGERY

SOLID DIET

SLEEVE GASTRECTOMY

NUTRITION AFTER BARIATRIC SURGERY

CLEAR LIQUID DIET

Zucchini Soup with Bariatric Labneh

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