Assoc. Prof. Erdinc Yenidogan

Obesity Surgery in Turkey

*

with individual attention, compassion and care for each patient

Transform Your Life with Obesity Surgery in Turkey

Obesity is a medical condition characterized by excessive weight gain and an increase in body fat, ranking as the second leading cause of preventable deaths following smoking. The development of obesity is influenced by a combination of genetic, environmental, dietary, and sociocultural factors.

 

Key Contributors to Obesity:

  • High caloric intake
  • Reduced energy expenditure due to decreased physical activity
  • An excessive number and size of adipose cells


Experience World-Class Obesity Surgery at Obemed in Turkey

 

Under the expert guidance of Assoc. Prof. Dr. Erdinç Yenidoğan, Obemed offers innovative and reliable obesity surgery solutions. Our experienced surgeon and advanced medical techniques provide personalized treatment plans. Achieve a healthier life with our globally recognized obesity surgery services.

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About

Why Obemed Clinic?

Gastric Sleeve Surgery Hospital Turkey

Unique Experience

Boasting over 10,000 successful laparoscopic surgeries in Turkey, Obemed Clinic is synonymous with unparalleled patient satisfaction and expertise. Our seasoned professionals ensure every patient’s journey is met with the highest standards of care.

Scientific Approach & Comprehensive Care

 

Select the most scientifically sound surgical methods for your condition, tailored in close consultation with our expert physicians. We prioritize a meticulous examination process both before and after surgery, paving the way for a secure and smooth recovery.

 

Dedicated Aftercare Support


Post-treatment, you are not alone; we provide extensive surgical and dietary support, ensuring you have a dedicated team available 24/7 for years to come.

650 million

Number of obese adults worldwide in 2016

WHO – Obesity and Overweight Key Facts

18%

Increase in global childhood obesity and overweight prevalence among 5-19-year-olds from 1975 to 2016

WHO – Obesity and Overweight Key Facts.

2.8 million

Deaths linked to obesity each year. The prevalence of obesity has almost tripled between 1975 and 2016

WHO facts on obesity

Our Practice

Meet the Founder

With over a decade of expertise in Obesity and Metabolic Surgery, Assoc. Dr. Erdinç Yenidogan has successfully conducted more than 6000 surgeries. A graduate from Istanbul University’s Cerrahpaşa Faculty of Medicine and a specialized General Surgeon since 2006, he boasts over 100 international publications and presentations. Fluent in English and German, Dr. Yenidogan is renowned in his field for both his surgical skills and academic contributions.

What is Obesity Surgery?

Gastric Sleeve Surgery in Turkey

Gastric sleeve surgery, a pivotal procedure in obesity surgery, involves the strategic removal of 70-80% of the stomach. This transformation reshapes the stomach into a sleeve-like structure, enabling patients to achieve early fullness with smaller food portions. Crucially, it maintains the functionality of the small intestine, thus safeguarding against post-surgery nutrient deficiencies.

By significantly reducing stomach size, the obesity surgery encourages controlled eating and effective weight management. It’s a procedure that not only facilitates weight loss but also supports overall health improvement, often aiding in the alleviation of obesity-related conditions. For optimal results, we recommend pairing this surgery with a nutritious, balanced diet.

Our approach to obesity surgery focuses on patient safety, well-being, and long-term success. Discover how this life-changing procedure can be a cornerstone in your journey towards a healthier lifestyle. For more details on the surgery and how it can benefit you, continue exploring our site or reach out to our expert team.

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How is Obesity Surgery Performed?

Gastric Sleeve Surgery Turkey

The laparoscopic obesity surgery is a minimally invasive procedure performed through small incisions on the abdomen, utilizing specialized tools and devices. The process involves separating the outer stomach wall and then delineating the portion of the stomach to be removed with a laparoscopic stapler—a device that seals the tissue on three layers. The staple line is then meticulously sutured to prevent bleeding and ensure safety, with the technique varying according to the surgeon’s preference and expertise.

 

Subsequently, the excised portion of the stomach is extracted from the abdominal cavity. To monitor for any potential leaks or bleeding, a drain is placed along the staple line, which, despite seeming daunting, is a critical safety measure in the operation. This drain is typically removed within 1-2 days post-surgery, without causing the patient discomfort.

 

The duration of the obesity surgery can range from 30 to 90 minutes, largely depending on the patient’s weight, anatomical factors, and whether they have had any previous surgeries.

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Obesity Surgery Process

Prior to obesity 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 obesity 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 obesity 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.

Frequently Asked Questions About Obesity Surgery

Obesity is a disease that develops due to excessive weight gain and is characterized by an increase in fatty tissue in the body. Elements such as excessive caloric intake, and less energy consumption due to decreased physical activity may also cause obesity. It is the second most common cause of preventable death, which comes right after smoking. The most disturbing aspect of obesity is the serious deterioration of quality of life. Men tend to gain more weight around the abdomen (central obesity), while women tend to gain more weight around the hips (peripheral obesity).


Obesity is classified by the body mass index (BMI). The body mass index; calculated by dividing weight (kilograms) by height squared (meters) (BMI = kilo (kg) / height2 (m2)). The obesity classification table of the World Health Organization is as follows:

 

Classification

BMI (Kg/m 2 )

 

Normal

18.5-24.9

 

Pre-Obese (Overweight)

25.0- 29.9

 

Class I (Obese)

30.0- 34.9

 

Class II (Severe)

35.0- 39.9

 

Class III (Morbid)

≥40.0

 

The primary treatment for obesity is diet. Exercising along with diet facilitates calorie expenditure and thus weight loss. Changing living habits (such as active life, healthy eating) facilitates both weight loss and maintaining the current weight.
If the attempt to lose weight with diet + exercise has failed, endoscopic or surgical options should be considered. Endoscopic approaches like Gastric balloon. At the beginning of the surgical options, Sleeve Gastrectomy surgery (Gastric Tube Surgery) comes first, while alternative surgical interventions are Transit Bipartition and Non-Diverted Ileal interposition surgeries.

There are numerous diseases associated with obesity. The main accompanying diseases when classified according to prevalence are;
Degenerative Joint Diseases, Lower Back Pain, Hypertension, Obstructive Sleep Apnea Syndrome, Gastroesophageal Reflux, Cholelithiasis (Gallstone), Type 2 Diabetes, Hyperlipidemia, Hypercholesterolemia, Asthma, Lethal Heart Arrhythmias, Right Heart Failure, Migraine, Venous Stasis Ulcer, Deep Vein Thrombosis, Fungal Infections, Skin Abscesses, Stress Urinary Incontinence, Infertility, Dysmenorrhea (Menstrual Irregularity), Depression, Abdominal Wall Hernias, Increased risk of cancer (such as uterus, breast, colon, and prostate)

The first criterion to be considered in patients who will be planned for obesity surgery is body mass index (BMI) and the lower limit is 40. In the presence of obesity and an additional disease (such as diabetes, hypertension, asthma, sleep-apnea), BMI should be over 35.

Other criteria sought additionally in patients who are planned for surgery are to have tried diet and exercise before, to be mentally competent to understand and accept the surgery to be performed, not to have a psychiatric disease, and not to have alcohol-substance addiction.

Obesity surgery is medically defined as bariatric surgery. The laparoscopic vertical sleeve gastrectomy (also known as gastric tube surgery) is the most commonly used and well-known method. It can simply be defined as the removal of approximately 70-80 percent of the stomach and giving the stomach an appearance of a tube/sleeve. The structure and integrity of the small intestines are not touched during the procedure, so the absorption process of foods is not impaired and therefore elemental vitamin deficiencies are not expected if the patient continues the oral intake. The reduction of the stomach size and volume, allows the feeling of satiety to occur earlier with less food consumption. A balanced diet, calorie restriction, and less food intake would allow the patient to lose weight controllable.

Apart from sleeve gastrectomy, other current bariatric surgery alternatives are Transit Bipartition and Non-Diverted Ileal interposition. Gastric Bypass should not be preferred because it causes rapid weight gain in the medium-long term.

The routine approach is to evaluate the patients in the preoperative period and to take possible precautions by determining the risks. All patients should be examined in detail during the process of planning the surgery. The main purpose is to detect and treat possible deficiencies and diseases before the operation, and, if necessary, postpone the surgery.

 

The assessments that have to be done for this purpose, are; evaluation of the lung (such as chest X-ray, pulmonary function tests, consultation from a pulmonologist), assessment of the heart (ECG, ECHO, cardiology consultation, and further examinations like stress ECG, Holter, or angiography if necessary), psychiatric evaluations (questioning the history of drug use, substance abuse, presence of psychiatric disease, and psychiatric consultation), surgical tests (abdominopelvic ultrasonography, doppler ultrasonography, history of previous abdominal surgeries), internal medicine (non-surgical) evaluations (existence of other diseases and treatments being used, internal medicine consultation, etc.), endoscopic exploration (visual assessment of the esophagus, stomach, and small intestine with endoscopy), laboratory tests (blood work, assessment of liver functions, kidney functions, and establishing the bleeding time).

 

The medications used by the patients should also be taken into account (such as blood thinners, antihypertensive and antidiabetic drugs, and psychiatric drugs). During the operation, some drugs should be discontinued or replaced with other medications, and re-continued after the surgery, as soon as possible.

 

In the presence of additional comorbidities (like previous operations, heart attack, lung infections, neurological and psychiatric diseases, hypertension, diabetes, and obstructive sleep apnea syndrome), the patient should be checked in the relevant department, and the evaluations and suggestions of the specialist there should be taken into account.

 

The medications used by the patient must be evaluated, and their use, dosage, or discontinuation in pre-and post-operative time should be planned.

High-risk patients must be hospitalized and treated before the operation.

The patient is discharged from the hospital in 2-3 days after obesity surgery. The first day of the operation is spent resting, water drinking and short walks are started at the 6th hour after the operation, and the next day, walks are continued at frequent intervals. On the second day, foods such as soup, ayran and juices are started, and on the third day,the patient is discharged.

 

After the Transit Bipartition and Non-Diverted Ileal Interposition surgeries, the hospital stay is 4 days in total.

In sleeve gastrectomy surgery, approximately 70-80% of the stomach is removed. The final state of the stomach after the procedure is similar to the shape of a banana.
In sleeve gastrectomy surgeries, the cutting of the stomach is done with a stapling system called as laparoscopic linear cutter staplers. Even if the staple line is safely closed after the procedure, bleeding may occur along the line. Scientific studies in recent years show that suturing the staple line significantly reduces the risk of bleeding in the early postoperative period. Similarly, it is known that suturing the line reduces the leakage rate. Therefore, we strongly recommend suturing the staple line in order to reduce the risk of surgical complications.
In Transit Bipartition surgery, approximately 40-50% of the stomach is removed.
In Non-Diverted ileal interposition surgery, approximately 70-80% of the stomach is removed. Similar to the Sleeve Gastrectomy procedure, the final state of the stomach is similar to the shape of a banana. Afterwards, displacement is performed in the small intestines.
Oral water intake begins in a controlled manner 6 hours after the operation. The next day, nutrition is provided with controlled fluid consumption and intravenous fluid support. In oral nutrition, clear liquid support is given (such as water, tea, sugar-free drinks, grain-free soups). Following the gas discharge of the patient, the transition to watery soups, yogurt, ayran, lactose-free milk, kefir is provided. This process continues until the end of the 2nd week. Between weeks two and four, a transition to a puree diet is made (eggs, omelettes, cream cheeses, fruit-vegetable purees, pureed vegetable dishes, meat-fish and chicken, minced meat). In addition, soft fruits can be consumed during this process. From the 1st month, a controlled diet with solid food is started. Dietitian support and recommendations should be followed throughout the nutrition process. We provide follow-up of our patients with a dietitian after the surgery.
Patients who have undergone surgery are followed up in their rooms after waking up and after the anesthetic evaluation, unless necessary. Except for special cases, patients do not stay in the intensive care unit.
In the first month after the operation, gastric protection and vitamin support drugs are given. After the first month, these drugs are released in a controlled manner. The use of supplements such as protein powder in the first month is left to the patient’s choice.
It is known that some diseases related to the loss of excess weight after surgery regress. Bone-joint disorders caused by excess weight gradually decrease and disappear in proportion to the weight lost. Hypertension begins to disappear due to the decrease in excess fluid load, drug dependence gradually decreases in patients using drugs, and drugs are discontinued under cardiology control. Similarly, the existing blood sugar level gradually decreases due to insulin resistance, and the use of existing pills is terminated under internal medicine control.
Post-operative walks are started as soon as possible. After the second week, sports such as brisk walking and swimming can be done. After the first month, weightless exercises can be started (such as pilates). As of the third month, weighted sports can be done easily (such as fitness, weighted exercises).
If the wound sites are closed subcutaneously (aesthetically) after the surgery, there is no need to remove the sutures. In patients whose stitches have to be closed normally, the stitches are removed after 12-15 days.
After the surgery, the existing insulin resistance returns to normal with weight loss and reduction of fat accumulation.
The period with the highest weight loss after surgery is the first month. The reasons for this are a low-calorie diet with liquid foods and the loss of excess fluid in the body, along with normal fat loss. After the balance is achieved, weight loss is parallel to the lost fat. The average weight loss seen in the first month is 5-15 kilograms. In the following months, the average weight loss is between 1-4 kilograms per month. The increase in weight loss is related to how active the person is and how much exercise they do.
Some patients may experience skin sagging after weight loss surgeries. What determines this is related to how overweight the person is, the presence of sagging before the surgery, and the rate of weight loss. It is recommended that surgeries related to sagging be postponed until after weight loss is complete.
After the post-operative staple line is healed, the stomach may stretch a little, but the stomach does not enlarge.
The weight loss status of the patients after the surgery is followed up on a monthly basis by contacting them. Blood evaluations are made in the 1st, 3rd, 6th, 9th and 12th months.
Surgery is not applied to patients with a body mass index below 30. Surgery is contraindicated to patients with severe heart failure, uncontrolled cardiovascular disease, end-stage lung disease, cancer or treated for cancer, cirrhosis in the presence of portal hypertension, uncontrolled substance or alcohol abuse, and people with severely impaired intellectual capacity.
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 sleeve gastrectomy 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.
The choice of surgical operation to be applied varies according to the patient’s condition. Factors such as body mass index and the presence of additional diseases are very important in determining the surgery to be performed. At the same time, all gains and complications of surgeries that can be performed should be understood and discussed with the patient. Your doctor’s opinion should be taken and applied to make the right choice.
Non-surgical options are diet+exercise, treatment with medications gastric balloon.
Gastric balloon is an endoscopic approach. The procedure is performed with sedation and general anesthesia is not taken. It is aimed to provide fullness and early saturation by placing a balloon endoscopically into the stomach. Depending on the type of balloon used, the duration of the balloon in the stomach varies between 6-12 months. Although the potential for weight loss is acceptable, rapid weight regain following the removal of the balloon is inevitable in approximately 90% of patients. Perhaps the only effective use of intragastric balloon placement is in super-obese patients (in patients who are planned for surgery but who cannot be operated due to high anesthetic risk) in order to achieve weight loss in a short time (for example, reducing the person from 200 kilograms to 170 kilograms) followed by surgery with relatively lower risks. Another patient group suitable for its safe use is those who want to lose weight but do not meet the surgical criteria (patients with a BMI of 25-30), for whom relatively less weight loss can be targeted. It can also be applied to patients who are not considering surgery.
The most successful and most permanent treatment method for obesity is surgical applications. Surgery provides the longest weight loss process, makes it difficult to regain the lost weight, and ensures the protection of the reached weight at the highest level. The proportion of patients who have reached the targeted weight and managed to maintain the weight they have achieved over the years is around 85-90%.

Reviews

What our
Patients Say?

Dr. Erdinc with Gastric Sleeve Patient

Overall Rating

4.8

4.7/5
from Google reviews >
"Initially, I was nervous about traveling to Turkey for gastric sleeve surgery, but it was absolutely the right choice. The care was exceptional, and the experience in Turkey added positively to my recovery."
Emily, 34Gastric Sleeve Patient
"Gastric sleeve surgery was a life-changer for me. It's not just the weight loss but the new lifestyle I've embraced. Dr. Erdinc's expertise really made a difference in my journey."
Michael, 42Gastric Sleeve Patient
"I never imagined feeling this energetic and healthy. Post-surgery, I've rediscovered my passion for design and outdoor activities. The whole process was smoother than I expected."
Sarah, 38Gastric Sleeve Patient
"Retirement feels like a new beginning after my gastric sleeve surgery. I'm enjoying life with more energy and better health, all thanks to the supportive medical care I received."
Linda, 65Gastric Sleeve Patient
"Initially, I was nervous about traveling to Turkey for gastric sleeve surgery, but it was absolutely the right choice. The care was exceptional, and the experience in Turkey added positively to my recovery."
Emily, 34Gastric Sleeve Patient

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