Why Obemed Clinic?

Prior to gastric sleeve surgery, it’s crucial to conduct a thorough preoperative evaluation to identify and mitigate risks. This involves a detailed examination to uncover and address any deficiencies or existing conditions. For this purpose, several assessments are conducted:

• Pulmonary Evaluation: Includes chest X-ray, pulmonary function tests, and a pulmonologist’s consultation.
• Cardiac Assessment: Consists of ECG, ECHO, cardiology consultation, with additional tests like stress ECG, Holter, or angiography as needed.
• Psychiatric Evaluation: Reviews the history of drug or substance abuse, existing psychiatric conditions, and includes a psychiatric consultation.
• Surgical and Internal Medicine Tests: Encompass abdominopelvic ultrasonography, doppler ultrasonography, previous surgery history, and internal medicine review for non-surgical diseases and treatments.
• Endoscopic Exploration: Visual examination of the esophagus, stomach, and small intestine.
• Laboratory Tests: General blood work, liver and kidney function tests, and bleeding time assessment.

Patients’ medications, including blood thinners, antihypertensive, antidiabetic, and psychiatric drugs, are carefully reviewed. Some may need to be adjusted or temporarily discontinued around the surgery.

For those with comorbidities like heart conditions, lung infections, neurological or psychiatric diseases, hypertension, diabetes, and obstructive sleep apnea, specialized consultations are necessary. Their recommendations are crucial in tailoring pre- and post-operative care.

High-risk patients may require hospitalization and treatment prior to surgery, ensuring optimal conditions for a successful outcome.

After surgery, patients are evaluated by the anesthesia team and, once cleared, moved to their rooms for further monitoring. Generally, intensive care is not necessary post-surgery, except in special cases like sleep apnea. Patients can begin drinking water in a controlled manner and start taking short walks 6 hours post-operation. The following day, walking frequency is increased alongside breathing exercises. Controlled consumption of liquid foods, such as seedless soup and compote, begins after gas discharge. The drain is removed during this period. To monitor clinical status and potential complications, patients typically stay in the hospital for 3 nights, with discharge scheduled on the 4th day.

Before discharge, a dietitian thoroughly explains nutrition details to the patient and their relatives. Additionally, post-operative medication and essential care points are meticulously outlined.

Postoperative diet and nutrition are explained under the control of a dietitian. Questions such as what should be eaten in the early process, at what speed and interval should it be consumed, what should not be eaten are answered.

Patients are given a 1-month diet program to follow. The main purpose here is not to weaken the patient quickly, but to ensure the safe healing of the surgical field and not to endanger the safety of the suture line with excessive-incorrect consumption.

From the first month, nutrition returns to normal in terms of consistency. In order to ensure a healthy life and controlled weight loss, foods that should not be consumed are explained in detail and the patient’s adaptation process and weight loss are monitored monthly.

The drugs that should be used in the first month after the surgery are stomach protectors, multivitamins and pain relievers if needed. These drugs are released in a controlled manner after the first month.

The drugs used in the pre-operative period are started again. In the case of regression of some weakening-related diseases (such as hypertension, hypercholesterolemia), the drugs used are left in a controlled manner in line with the knowledge and recommendation of the relevant physician.

Although every surgical intervention has some complications and risks, there are complications and risks specific to each surgery. What scientifically important is the occurrence and treatability of these complications.

Complications that can be seen in laparoscopic metabolic surgery are; bleeding through surgical incisions, wound problems (such as surgical site infections, and poor wound healing), specific complications (like surgical site bleeding, and leaks after the disruption of the site’s integrity), positional complications of the structural integrity of the stomach (strictures throughout the passage, twisting of the stomach around itself (torsion), etc.), post-surgical complications unrelated to the surgical site (such as lung infections, urinary tract infections, heart problems), long-term complications (weight loss faster or slower than expected, ineffective/inactive weight loss or weight gain, vitamin and mineral deficiencies).

The incidence of these complications ranges from one percent to 1 in 10 thousand to even 1 in 100 thousand. At this point, what’s important is the early diagnosis of preventable complications and the application of appropriate treatment when they occur. Likewise, identification of the causes that increase the risk of complications even before the surgery (such as the presence of other diseases, smoking, alcohol, other factors affecting wound healing, or other diseases that may increase the adverse side effects of anesthesia) and if necessary removing these risk factors first, reduces the prevalence of the complications considerably. Similarly, precautions for postoperative complications can be taken (such as early mobilization, respiratory muscle training, strict aftercare and follow-up, and early initiation of appropriate medical treatment) to ensure the process is completed without any problems.

Another important point in the postoperative period is the early detection and appropriate treatment of undesirable complications. The fact that “Early diagnosis saves lives”, which is always said in diseases such as cancer, is valid for every aspect of medicine, especially in surgical complications. Unfortunately, failure to diagnose a complication at an early stage that can be brought under control with appropriate treatment can cause the situation to worsen and may become uncontrollable and untreatable. Therefore, it is important to inform and check in with the patients at every step and to follow up with the patient closely after the surgery. It should never be forgotten that the experience and knowledge of the surgical team is the most important component in the management of surgical complications.