What is metabolic surgery?

Metabolic surgery is performed to treat conditions such as high blood pressure, obesity, type 2 diabetes, and high cholesterol. If metabolic diseases are not treated with this surgery, they reduce the quality of life and lead to serious health risks. This surgery is called metabolic surgery due to the treatment of metabolic diseases. With the progress and development of science and new surgical methods in recent years, the success rate of metabolic surgery treatment has increased greatly. This method is used as a quick treatment method, especially if the disease is diagnosed early.

Quick access - What are metabolic syndrome diseases and how are they diagnosed? - Definition of metabolic surgery - How is metabolic surgery performed? - How to make a decision about doing metabolic surgery? - Why should metabolic surgery be performed? - Risks of metabolic surgery - Benefits of metabolic surgery - Conclusion

What are metabolic syndrome diseases and how are they diagnosed? Metabolic diseases are a group of diseases that increase the risk of stroke, diabetes and heart diseases. To determine whether you have metabolic diseases, you must have at least three metabolic risk factors. The risk factors of this disease in people are as follows: - **Abdominal obesity:** Large waist circumference that indicates abdominal obesity or apple-shaped body shape. Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as the hips. - **High glyceride level:** Triglyceride is a type of fat found in the blood. - **Low level of cholesterol:** Low level of HDL cholesterol is sometimes considered good cholesterol; Because it helps remove cholesterol from your arteries. Low levels of HDL cholesterol increase the risk of heart disease. - **High blood pressure:** Blood pressure is the force that blood pushes against the walls of your arteries while your heart pumps blood. If this pressure rises over time and remains high, it can lead to heart disease or plaque. High fasting blood sugar: High blood sugar may be one of the early signs of diabetes.

Definition of metabolic surgery Metabolic surgery, in simple terms, is surgery that is performed to treat metabolic syndrome diseases, especially type 2 diabetes, which is not just one specific method and has many types. The surgical method is chosen according to the disease and the patient's condition. The main goal in metabolic surgery is to ensure that the nutrients entering the body come into contact with the bile and pancreatic fluids. In this way, substances that activate the production of insulin, the pancreas starts to secrete and increases the level of insulin. How is metabolic surgery performed? All metabolic surgeries are performed using the laparoscopic method, which is also known as the closed surgery method. In this way, no incision is made on the patient's body, but the surgery is performed by inserting the device through four or five holes. The duration of the operation depends on the chosen method for surgery and is different in each method; That is, it may take 1 or 3 hours depending on the method. After the surgery, the patient may stay in the hospital for 4 or 5 days. Different methods of metabolic surgery are: - Sleeve gastrectomy - Mini Gastric Bypass - Derivatives of the duodenal switch - Gastric bypass - Transit of two partitions - Intestinal displacement derivatives The most common metabolic surgery methods are laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. These methods are also minimally invasive methods of weight loss that are usually performed on obese patients. In the following, we will describe each one. ### Laparoscopic sleeve gastrectomy In this method, the stomach is stretched to the size of a long narrow tube in the shape and size of a banana, which limits the amount of food the patient can eat and increases the effect of intestinal hormones to reduce blood sugar.

Gastric bypass is a surgical procedure that creates an egg-shaped pouch in the upper part of the stomach, which is then connected to the lower part of the small intestine in a "Y" configuration. After this procedure, the food is diverted by this bypass and absorbed only in a small part of the intestine. How to make a decision about doing metabolic surgery? Before deciding to perform metabolic surgery, the patient should be tested and these tests should be checked carefully. The patient's body mass index should be above 40 or more than 30, blood sugar should not be controlled by other treatments, and there should be no other option than surgery. At the same time, the level of hemoglobin A1c should be considered for a patient who has had diabetes for several years and has taken insulin. The most important criteria for patients to decide on surgery is that the pancreas continues to secrete insulin. The status of the pancreas is determined by tests performed before the operation. The patient's obesity level is also evaluated. People who are diagnosed with diabetes and do not need insulin therapy and use low doses of medication have a higher chance of surgery. Why should metabolic surgery be done? The most definitive method to treat type 2 diabetes is metabolic surgery. Although the priority in the treatment of type 2 diabetes is to control the patient's lifestyle, sometimes it is not possible to keep the blood sugar level at an optimal level by only changing the lifestyle and controlling the diet. If the patients have the possibility of surgery from the doctor's point of view, the best and most definitive method of treatment is surgery. Apart from diabetes, this method is also effective in diseases caused by metabolic syndrome. After this treatment, most patients will no longer need to take medication, and some will continue to take medication in very low doses.

Usually, all surgeries have risks and complications; But when the risks of the operation and the risks of treatable diseases are compared, it is clear that the risk of surgery is much lower. The most important point in performing the operation is to correctly check the health status and progress of the person's disease and perform the operation by a skilled surgeon. Completing the entire process correctly, from the patient assessment process to the operation and post-operative controls, is very important to ensure minimal surgical risk. Benefits of metabolic surgery The benefits of metabolic surgery include: - **Weight loss:** Significant weight loss is achieved by metabolic surgery, which is stable in the long term. - **Improving diabetes control:** Significant weight loss caused by surgery leads to significant improvement in type 2 diabetes. - **Improving metabolic diseases:** This surgery improves diseases such as heart disease, high blood pressure and high cholesterol, non-alcoholic fatty liver disease, sleep apnea and asthma. - **Improvement in the quality of life:** Weight loss caused by surgery also generally improves well-being and quality of life. Conclusion Metabolic syndrome diseases can reduce your quality of life or lead to serious risks such as stroke or heart disease for the patient. Therefore, seeing the symptoms of this disease, see a doctor for a definitive diagnosis and to choose a treatment method. In some cases, there is no treatment other than metabolic surgery to treat these diseases, which, if performed by a skilled surgeon, will not cause any serious complications and the risks are less than the disease. So don't worry about surgery and leave the decision and choice of surgery to your doctor.

Dr. Abdul Hosseini

Surgeon and advanced laparoscopic surgery fellowship, bariatric and metabolic surgery, metabolic surgery for the treatment of type 2 diabetes