Is Bariatric Surgery Dangerous?

It is possible to treat both obesity and Type-II Diabetes effectively with surgery in appropriate and carefully selected patients. With the widespread use of laparoscopy, that is, inflating the abdomen with air by entering the body with a few millimetric incisions, and the application of surgery with video guidance, this type of surgery has become more common. With the laparoscopic method, both the surgical field is seen better and the postoperative pain is less. Recovery after surgery and returning to work may be earlier.

After diabetic (metabolic) surgery, diabetes begins to improve even while the patient is still in the hospital. In other words, diabetes control occurs even before the weight loss process begins. Here, breaking insulin resistance after surgery plays a fundamental role. Improvement in glycemic control is observed in 70-80% of the patients, and the need for external insulin injections disappears or decreases in the vast majority.

Of course, these surgical methods, which have important advantages, also have some risks.

Among them:

- Anastomosis (Connection) leak

- Internal herniation (internal herniation)

- bleeding

-   Ulcer

- Torsion-stomach rotation

- Pulmonary embolism

- Intestinal Obstruction

- Trocar site hernias

- dumping syndrome

- Metabolic disorders

- Vitamin and mineral deficiencies can be counted.

Just like in drugs; If the benefit is more than the harm, the drug is defined as a poison if the benefit is less than the harm, and the benefits of these surgeries outweigh the harms. The metabolic burden imposed on the patient by both obesity and diabetes decreases and a significant clinical improvement occurs. The most feared complication is anastomotic leakage.

Anastomotic Leak Symptoms

Anastomotic leaks are observed at an average rate of 1.5-6% all over the world, depending on the type of surgery and the experience of the surgeon. They can also be life-threatening at times. For this reason, both prevention and early detection and intervention are of great importance.

- Increased heart rate

-   Fire

-   Stomach ache

- Abnormal discharge from the wound or from a drain placed in the abdomen

- Nausea-vomiting

- Pain in left shoulder

- low blood pressure

- Decreased urine output can be counted.

Diagnosis and Treatment of Anastomotic Leak

In the diagnosis, it is important to show that the oral contrast material has escaped from the stomach pouch or anastomosis line to the abdomen. For this, it is necessary to shoot real time movies under the scope. However, it is not always possible to detect with these films. In this case, abdominal tomography is often performed. When a leak is detected, it is followed up in the hospital. Oral intake is discontinued. Nutrition of the patient is provided with nourishing serums, which we call total parenteral nutrition. Strong antibiotics are started intravenously. If there are non-draining abscesses or areas of fluid collection, a drain can be placed by an interventional radiologist under ultrasound guidance.

If there is a leak-related infection, it is drained, repaired, or surgically reconnected. One or more of these treatment methods can be applied according to the clinical condition of the patient, the location and severity of the leak. Sometimes, it may be necessary to prevent the continuation of leakage by placing a temporary stent to cover this leakage area between the stomach pouch and the small intestine by endoscopic method. In this way, bleeding and infection due to anastomotic leakage are prevented. Anastomotic leaks can be serious and fatal. It is important for the patients who are considering surgery and the surgeon to discuss the possible risks in detail before the surgery, in order to ensure a healthier communication in case of the development of this type of undesirable complication, the compliance of the patient and his relatives with the treatment, and better results.

What Should Be Considered After Anastomosis Treatment?

After undergoing treatment for an anastomosis, several factors must be considered to ensure successful recovery and long-term health.

Here are some important points:

 -  Post-operative care: Follow the specific instructions provided by your healthcare professional regarding wound care, medications, and any activity restrictions. Attend all scheduled follow-up appointments to monitor your progress.

 -  Diet and nutrition: Follow all dietary recommendations provided by your healthcare professional. After an anastomosis procedure, you may need to change your diet temporarily to allow healing and to avoid putting excessive pressure on the surgical site. Gradually reintroduce solid foods as recommended and maintain a balanced diet to support recovery and overall health.

 -  Physical activity: Do regular physical activity as recommended by your healthcare professional. Physical activity supports circulation, aids digestion and helps maintain a healthy weight. However, avoid strenuous activities or heavy lifting until approved by your healthcare professional.

 -  Symptom monitoring: Pay close attention to any unusual symptoms or complications after anastomosis treatment. Common symptoms may include pain, swelling, fever, redness, discharge, or changes in bowel movements. If you experience any related symptoms, contact your healthcare provider immediately.

 -  Medication management: Take prescription medications as directed by your healthcare professional. This may include pain medications, antibiotics, or other medications to prevent complications or manage certain conditions.

 -  Lifestyle changes: Depending on the reason for the anastomosis treatment, your healthcare provider may recommend certain lifestyle changes. For example, if you've had a gastrointestinal anastomosis, you may need to change your eating habits, such as eating smaller meals or avoiding certain foods that may cause discomfort.

 -  Emotional well-being: Surgery and recovery can be physically and emotionally challenging. Take care of your mental health and get support if needed. Reach out to loved ones, join support groups, or consider counseling to help you manage any stress or emotional anxiety.

 -  Long-term monitoring: Some anastomosis procedures require long-term monitoring to assess the success of treatment and prevent future complications. Follow-up appointments and regular check-ups with your healthcare provider are essential to ensure the continued health of the surgical site and surrounding tissues.

Remember, these are general guidelines and it is important to follow the specific advice and instructions given by your healthcare professional as they will have the most accurate information about your individual case.