admin

Constipation is one of the common complications following weight loss surgery. Reorganization of the intestines, changes in the shape of the stomach or a definite change in diet can trigger constipation.

However, patients can avoid this situation by following an appropriate diet and doing certain home remedies. But even if it happened to you, it can easily be eliminated. Let’s take a look at the reasons for constipation and how you can get rid of it.

Why Does Weight Loss Surgery Cause Constipation?

• The lower amount of food intakes compare with you pre-surgery life
• Taking iron supplements
• Regular use of chronic pain relievers, antidepressants or tranquilizers
• The person’s abdominal muscles are weak and the intestines are prone to laziness
• Not drinking enough water during the day
• Insufficient consumption of diuretics
• Inactivity
• Insufficient dietary fiber intake

How Can I Avoid Constipation After Weight Loss Surgery?

It is better to take precautions before you encounter post-surgery constipation. Applying a few methods, you can completely prevent the occurrence of constipation or you can minimize its symptoms of constipation to a minimum.

• Add 2 or 3 tablespoons of direct fiber to a glass of water. You should repeat this process 2 times when you consume fibrous vegetables during the day, and 3 times when you do not consume them.
• You should consume beans regularly.
• Drinking water is a big help in preventing constipation. Be alert to drink 8 glasses of water a day. Consuming too much water will not cause an enlargement or discomfort for your stomach.
• After your surgery, you should walk regularly for at least 5 minutes a day. You should keep your walking time as long as you can. After you start to feel better (approximately 1 month after the operation), you should start doing sports at a low pace.

How Do I Know If I’m Constipated?

You are constipated if you have at least 3 of the following symptoms;

• If you have bowel motility less than 3 times a week and you go to the toilet less than 3 times a week
• If your stool is dry, lumpy or has a hard form
• If you have difficulty and pain in defecation
• If you often experience abdominal pain and abdominal cramps in normal times
• If you feel bloating or nausea in your abdomen during the day
• If you do not feel that you have emptied your bowels enough after going to the toilet

How Do I Prevent Gallstones from Forming After Bariatric Surgery?

Another common complaint after bariatric surgery is the formation of gallstones. After your surgery, your doctor will prevent the formation of gallstones with ursodeoxycholic acid dose treatment for the prevention of gallstones.

In addition, your diet plays an important role in the formation of gallstones. Consuming at least 5 servings of vegetables or fruits during the day will prevent the formation of gallstones.

How to Relieve Constipation After Tube Stomach Surgery?

It is possible to pass constipation with a few recipes at home.

• Olive oil: Consume one tablespoon of olive oil and one teaspoon of lemon juice on an empty stomach.
• Warm water and lemon: Mix 1 cup of warm water (it should be higher than room temperature but lower not too hot) and the juice of half a lemon. Drink the entire glass at once. (Those with blood pressure problems should only use a few drops of lemon).
• Molasses: Have a teaspoon of molasses by mixing it with warm water or tea if you wish.
• Fiber: Consume high fiber foods such as broccoli, peas, peaches, grain-free bread, nuts, potatoes, apples and pears.
• Exercise; You should increase your exercise amount. Walking during the day helps to move your intestines.

What should I do to go to the toilet?

• Exercise: The more you exercise, the more your intestines will be activated.
• Warm water: Warm water is much more effective for relieving constipation than you might think. Consuming warm water makes your intestines move quickly.
• Olive oil: Swallowing a tablespoon of olive oil directly helps to lubricate and move the stool in your intestines. In addition, if you have pain in your anus area caused by constipation, you can apply olive oil before going to the toilet.

What to Eat After Stomach Reduction Surgery?

• Lean ground meat, poultry or fish
• Cottage cheese
• Not very cooked omelet
• Rice or similar grain
• Soft fruits and boiled vegetables
• Strained cream soup

Here’s a complete guide on what to eat and what not to eat after bariatric surgery.

You can also puree your solid foods with these;

• Unsweetened fruit juice
• Skim milk
• Meat Water

Which Soups Are Drinked After the Surgery?

The soups you will drink after the surgery should be pureed, sparse soups containing plenty of water. You should take care that there are no grains in your soups.

You should also avoid adding spices or salt to your soup. You can use broth to both increase the amount of protein and flavor your soup.

HIPEC chemotherapy, which is the short form of hyperthermic intraperitoneal chemotherapy, is a special surgical oncology treatment that might provide hope to those who have complex and advanced abdominal cancers and usual chemotherapy drugs are not effective to them anymore. Using heated, sterilized chemotherapy solution, this cancer treatment procedure is performed after the cytoreductive surgery to kill the microscopic cancer cells that might have not been found and destroyed during the surgery. 

The combination of HIPEC and CRS (cytoreductive surgery) makes an effective solution for many cancer patients. However, the procedure has its own risks and is not suitable for all patients. This article explains the benefits of this treatment, how it is done, what its risks are, and who it’s for. 

Which Types of Cancer Are Treated with This Procedure?

Cytoreductive surgery and HIPEC are performed to treat several types of gastric cancer:

• Colorectal cancer
• Appendiceal cancer
• Ovarian cancer
• Colon cancer
• Stomach cancer
• Primary peritoneal cancer
• Pseudomyxoma Peritonei (PMP)
• All cancers in the peritoneal cavity

Cytoreductive Surgery

Cytoreductive surgery is the first step of this procedure. As chemotherapy treatments are less effective for treating cancers in the abdominal cavity, when the spread of disease in the abdomen is limited and patients have the qualifications, a major operation is performed by a team of surgeons.

A typical operation may involve a combination of removing some of the peritoneum and the abdominal areas affected by cancer spread. This operation lasts an average of 8-10 hours depending on the extent of the disease.

A typical operation may involve the removal of part of the colon or rectum, organs such as the gallbladder or spleen. In women, the uterus or the womb and ovaries are removed. 

The momentum, a fatty apron that lives inside the abdomen, is removed. And again the peritoneum, the lining of the abdominal organs or abdominal wall is removed. Also, a toma needs to be formed, either temporary or permanent.

The steps of the surgery:

• An incision is made into the abdominal wall
• Doctors assess the extent disease involvement and organs affected
• Using various surgical techniques, they remove as many tumors as possible.
• After the tumors have been removed, the HIPEC procedure begins.

HIPEC Procedure

After the surgery, there is a possibility the microscopic cancer cells remain. That’s why hyperthermic intraperitoneal chemoperfusion must be done right after the surgical process. During this procedure, high doses of heated chemotherapy can penetrate and destroy cancer cells that are left out in the abdomen after surgery.

Immediately following the cytoreductive surgery the surgical team performs the HIPEC treatment. As mentioned before, HIPEC is essentially a chemotherapy bath or wash that delivers chemotherapy directly to the abdominal cavity usually for an hour with the intention of killing any remaining cancer cells that were not a visible tumor and hence not seen with the naked eye.

The tubes are connected to a machine that both heats and pumps the solution allowing continuous circulation of the chemotherapy solution.

The temperature probes allow the temperature of the solution to be measured constantly.

The steps of HIPEC are as follows:

• Temperature probes are placed on each side of the abdominal wall
• Then, two inflow catheters are placed in the lower abdomen.
• And two outflow catheters are placed in the upper abdomen.
• The catheters are attached to tubes connected to the profusion machine, which warms, administers, and controls the temperature and flow of the chemotherapy solution.
• The temperature probes allow the surgical team to monitor the temperature of the solution within the abdomen.
• The abdomen is then temporarily sutured close for the procedure
• Sailing solution through the inflow catheters.
• The solution is warmed to the necessary temperature.
• Chemotherapy is added to the solution in 2 doses over a 90-minute period.
• The pump of the profusion machine delivers the solution into the abdomen.
• The solution flows back to the machine where it’s warmed and redelivered into the abdomen.
• This cycle continues.
• At the end, the chemotherapy solution is drained from the abdomen.
• The surgeon reopens the abdomen and the probes and catheters are removed.
• The whole procedure takes 6-12 hours to complete.

 Benefits of HIPEC

HIPEC is not the solution for all cancer patients. However, for people who have advanced surface spread of cancer within the abdomen without disease involvement outside of the abdomen. Overall, HIPEC is an effective treatment for cancer because it:

• Allows for high doses of chemotherapy
• Enhances and concentrates chemotherapy within the abdomen
• Minimizes chemotherapy exposure and side effects
• Improves chemotherapy absorption and susceptibility of cancer cells

Am I Qualified for HIPEC?

Each individual’s case differs from another. Therefore, to assess a patient’s eligibility, a team of doctors, surgeons, radiologists, pathologists, and chemical nurse specialists of a specialized medical center consult and perform diagnostic studies to find out whether each patient needs this treatment or not.  But there are special circumstances that make patients unsuitable for this process. 

For instance, eligible patients should not have disease in multiple sites or disease in the abdomen which is too widespread, then they’re unlikely to benefit from this type of surgery. Each patient is assessed individually and treatment or a surveillance plan is put into treatment.

Life After HIPEC

The entire process is really invasive and it takes 3 to 4 months for patients to recover completely. You have to stay 7-10 days in the hospital, which is not a short time in comparison with many types of surgery. During this time, your digestive system needs to recover from the intense dose of chemotherapy it has received. Nutrition is given to patients via a feeding tube. 

During your recovery time at home, make sure to take a walk every day as it decreases the chance of post-surgery complications. 

If you feel tired most of the time, don’t worry. It’s totally normal and will continue for 2 or 3 months. Remember, your body has been through a lot. Give it time to heal. But try to stay active, even if it means brief, small, daily activities. 

Wait for at least 2 months before you restart your sexual activity. Listen to your body. Don’t be hard on yourself. 

If your job does not require heavy physical activities, you can go back to work within a month. 

Driving is not recommended sooner than 7 to 8 weeks after the surgery. 

If you have to travel after your surgery or you choose medical tourism for your treatment, ask your airline for a ‘curb to curb wheelchair’. Ask your surgical oncologist or your surgeon to evaluate your nutrition status because your calorie needs after surgery must be met. 

In general, you can eat well-cooked vegetables, white bread, plain pasta, white rice, etc. And please, don’t forget your follow-up sessions. Even 4 years after the surgery, you need follow-ups every 6 months. 

Side Effects

Serious complications are seen in between 10-15% of patients. The most common side effects are Bleeding and asthmatic leak which happens when the bowel ends that have been joined together do not heal. It most of the time needs antibiotics, sometimes a drain, and even a second operation.

Another common risk is fluid collections within the abdomen. This might require the insertion of a drain into the abdomen under x-ray guidance blood clots within the leg. This is called deep vein thrombosis.

Other complications are:

– Wound, chest, and urine infections

– Fistulas

– Kidney failure

– Abscesses

– Hemorrhages

– Bloating

– Constipations

– Diarrhea 

– Depression 

– Pain

– Vomiting

– Weight loss

– Fatigue

Even though the side effects are not limited, most of the time HIPEC does not have

the usual side effects of traditional chemotherapy.

Also, infections might be treated with antibiotics. Severe infections may require more aggressive treatment. The last point is that if a team of professional surgeons performs the process in a specialized center, the side effects won’t be more than the risks of other types of digestive surgery. 

Call your doctor when:

– Fever higher than 101 degrees Fahrenheit

– Uncontrollable pain 

– Redness beyond your incision

– Nausea or vomiting for more than one day

And basically any other circumstances you find intolerable. 

About the cost of cytoreductive surgery and HIPEC, we will talk more in the next article as we give you information about the cost of the procedure in different countries and what factors affect its cost. 

Death and Survival Rate of HIPEC

Safety concerns and analysis of morbidity matter a lot to cancer patients before making a decision. Even though the process is risky, in comparison with other treatments for cancer, the survival rate is higher. According to a review of morbidity, the 30-day mortality rate of HIPEC was 1.1%. Median improved survival is not fixed for all patients, but it varies from 22 to 47 months. Also, the 5-year survival rate is 27% to 54%.

Even though the combination of Cytoreductive surgery and HIPEC (Hyperthermic Chemotherapy) is an aggressive surgery, sometimes it’s the only hope left to the patients, especially the ones who have tried different chemotherapeutic agents yet still are dealing with advanced stages of abdominal cancer and peritoneal tumors. This abdominal surgery is performed with the aim of killing all the cancer cells, both the invisible and visible tumors.

One of the major concerns of cancer patients is whether this expensive procedure is worth all the pain and money. If you’ve made your decision to undergo HIPEC and cytoreductive surgery but can’t afford its high cost, there are still ways to do it in a standard condition but for a lower price. One of them is medical tourism and Turkey’s fame in medical tourism has made it a popular center for cancer patients as well.

What you should know is first and foremost your eligibility for a HIPEC procedure. Second of all, is Turkey a really safe place to do the process? And last but not least, is HIPEC surgery in Turkey a beneficial or risky treatment for you?

Is HIPEC a Cost-Effective Procedure?

Of all the treatment methods for cancer, this intraperitoneal chemotherapy has been proven to be more cost-effective and successful in eliminating cancerous cells in comparison with other treatment types such as palliative chemotherapy. 

According to a study, the average cost of CRS and HIPEC is almost S$83,680.26 for each patient. Moreover, the overall duration of median survival of patients was 47 months. For patients who experienced Cytoreductive surgery and HIPEC, the calculated cost per life-year was S$21,365.19 per life year. This number is almost S$44,478.87 for patients who undergo palliative chemotherapy. Their overall median survival was months.

In general, the cost of each session of intravenous chemotherapy and long-term systemic chemotherapy might be cheaper, but the overall costs, in the long run, will be more

What Types of Cancers Are Treated with HIPEC in Turkey?

CRS and HIPEC procedures are done in Turkey following the same surgical procedures in other countries. You can read more about the details of this process and watch videos of it in our article about HIPEC cancer treatment. 

In Turkey, this surgery is performed to treat different types of peritoneal cancer including ovarian cancer, colorectal cancer, and other types of abdominal cancers. However, they’re not for everyone and proper patient selection is done by a team of surgeons. 

Why Is HIPEC cheaper in Turkey?

The difference in HIPEC cost in Turkey and other countries has one major logical reason: the lower cost of life in Turkey which causes the costs of surgery to be was lower. 

For example, even though surgeons are among the high-paid professionals in Turkey, as well as other countries, the salaries of a surgical team that is responsible for the process are still lower than in the US or Europe. 

Except for the surgical equipment, if you calculate the other costs of medical centers and hospitals in Turkey, including human resources and the costs for keeping the hospitals up and running, and then calculate the sum of that in dollars, you’ll see the difference. 

But some people might think the reason for this low price is that the quality of medical care in Turkey is not the same as in developed countries. But the truth is vice versa. 

Are Hospitals in Turkey Credible and Qualified?

Turkey has 46 JCI accredited hospitals, 29 of which are in Istanbul, and a handful of standard medical centers. Because of the popularity of medical tourism in Turkey, accepting foreign patients and providing them with quality medical services is not a new thing. Patient safety, especially for the ones that are miles away from their own countries or cities, beholds great importance. 

According to the numbers announced by the Ministry of Culture and Tourism, on average, each year 1 million and 700 thousand people travel to Turkey for medical purposes. The two major reasons for the popularity of Turkey among medical tourists are the affordable price and the high quality of health care services in addition to the expertise of Turkish surgeons. 

Is There Any Additional Cost?

Generally, traveling with the purpose of using medical services in another country means you have to pay additional costs such as a plane ticket. However, the difference between the medical costs in your country and the destination country is sometimes so noticeable that these additional costs are nothing. 

Medical tourism is not a new trend in Turkey. Medical centers have been accepting patients from all around the world for a long time. As a result, there are all-inclusive medical packages that minimize the non-medical costs for the patients. These packages include transportation, accommodation, translation services, medical tests before and after the procedure, and so on. 

When talking to a medical center and asking for their price, make sure to ask exactly what this price includes. Then, you can make a better decision. 

But the significant point about undergoing HIPEC surgery in Turkey is not the cost, but whether you’re eligible for this procedure, especially in Turkey or not. 

Am I Eligible for HIPEC in Turkey?

Unfortunately, there’s no fixed, easy answer to that. This palliative surgery is mainly for patients who are dealing with advanced stages of abdominal cancer and have no other treatment options. But having these circumstances does not necessarily make you a qualified candidate for CRS and HIPEC.

After finding your surgeon, a team of doctors and surgeons should thoroughly assess your medical case including your tests, conditions, previous cancer treatments, and surgical oncology attempts. Making the proper decision might take one or a few long consultation meetings and then you will be informed of the result.  

If you’re among high-risk patients, your surgeon will tell you your survival rate and what the best decision is. In some cases, medical tourism makes the management of complications difficult, especially when you’re back in your own country. This factor is highly effective in your progress and survival rate after the surgery. After all, the postoperative complications are not just a few because almost all parts of your abdominal organs might be affected. 

The evaluation of patients for surgery must be done carefully and from all aspects using prospective studies, which is why a team of surgeons makes this decision. 

Mortality Rates of CRS and HIPEC in Turkey

Is the survival rate of HIPEC surgery in Turkey higher than in other countries? Is my chance of waking up after the surgery lower in Turkey? Any patient who is researching this procedure in Turkey has these questions. The answer is no. The death rate of HIPEC surgery in Turkey does not differ from other countries because only patients who are eligible to have the procedure in another country and can stay in Turkey for at least two weeks are accepted by Turkish surgeons. 

Let’s have a review of the general mortality rates of HIPEC. This surgical process is an invasive one, hence the associated morbidity rates are high. However, according to reports, the survival rate of selected patients with peritoneal carcinomatosis in these reports was high as well. 

Reports of a single institution in Japan reveal hopeful results on procedures performed on patients with peritoneal carcinomatosis (PC) from colon cancer and gastric cancer and ovarian cancer patients. The mortality rate of these patients was 3.5% and reoperation was necessary in 11% of the cases. 

The significant point is that HIPEC noticeably reduced postoperative complications. 

HIPEC Surgery Cost

Because of the sensitivity of the procedure and its difficulty, HIPEC is amongst the most expensive surgical procedures in the world. In most European countries and the US, the price of CRS and HIPEC is on average 80,000$. Below is a list of the average cost of CRS and HIPEC all around the world. 

Finland: 89,000 $

Russia: 87,000 $

England: 85,000 $

Denmark: 83,000 $

Estonia: 83,000 $

Germany: 80,000 $

America: 80,000$

Italy: 78,000 $

Poland: 77,000 $

France: 75,000 $

Ireland: 75,000 $

Lithuania: 70,000 $

Mexico: 45,000 $

India: 43,000 $

Turkey: 30,000 $

Bariatric surgery is a challenging process, both psychologically and physically. The readiness of patients will help eliminate the complications and side effects that might occur in the future and increase the success rate of the surgery. The more information our surgeon has about your general physical and mental status, the better they can control your post-operative situation. Let’s take a look at all the examinations you should take before weight loss surgery.

Examinations Before Obesity Surgery

Before the obesity surgery, patients should take different tests so that their surgeons can take into consideration the patients’ current health status using the test results. These tests include:

• Blood test to reveal the patient’s vitamin status, hemoglobin level and other factors.
• Urine: a urine test is used to diagnose diabetes, biliary or kidney problems.
• Endoscopy: Stomach scanning is performed with an endoscopic instrument delivered through the mouth or nose.
• Swallowing Test: This test is performed by drinking a special liquid to understand the severity of acid reflux and problems in the food path.
• Pulmonary Function Test: It is a test that gives information about the lungs, measured by taking a deep breath and exhaling.
• Check Up: a whole body scan helps diagnoses of the patient’s phsyical diseases.
• Alcohol test: Patient’s alcohol use is directly related to weight gain. For this reason, the amount of alcohol in their blood should be measured.
• Upper Abdominal Ultrasound: the ultrasound examination of the upper abdomen (liver, gall bladder, pancreas, kidney, spleen, etc. located in the upper part of the abdomen) is performed for patients with smoking habits.
• Colonoscopy: the process of examining the large intestine with a special camera.
• Mammography: for the diagnosis of breast cancer and its associated problems.
• Interview with the dietitian: The patient gets information about nutrition by meeting with a dietitian before the surgery.
• Psychiatric Evaluation: in addition to being physically healthy, people should also be psychologically ready for this situation and be healthy enough for surgery.
• ECG: heart values, respiration and similar information are obtained by walking the person on a tape.
• Ultrasound: ultrasound is especially performed for patients who experience pain in the upper right part of their abdomen.
• Thyroid Test: the health status of the thyroid is checked by taking a blood sample.

Why Does Your Diet Before Surgery Matter?

People who want to lose weight with bariatric surgery should start a special diet at least 2 weeks before the surgery date, but what is the point of this diet?

• The lower your weight is before your surgery, the less complications you’ll encounter in your post-operative life. Both you and your doctor will experience more comfortable results after the surgery.
• After the surgery, a tough diet awaits you. So, quiting your unhealthy habits after the surgery might bring about depression or serious physical risks. The nutrition program you will do before the surgery will allow you to easily adapt to the diet and new eating habits after the surgery.
• Extremely obese patients are much more likely to encounter complications during or after bariatric surgery. Eating carefully before the surgery will reduce the risk of complications as it enables you to lose weight.
• It is important to reduce the size of your liver fat and abdomen before surgery. Eating carefully and avoiding fatty foods will help you with this.

Your diet before the surgery does not need to be extremely limiting. You should only practice getting rid of your bad habits and eliminate unhealthy nutrition from your life.

What to Eat and What Not to Eat Before Obesity Surgery

You can simply follow these guidelines;

• Avoid saturated fats, and if possible, do not consume them at all. Do not consume full-fat dairy products, fatty meat, fried foods and other foods containing saturated fat.
• Stay away from carbohydrates. You should not consume sweets, pasta, potatoes, bread or other pastries made with flour which are high in carbohydrates.
• Sugar should be off your tables. You need to remove sugary drinks, sweets, chocolate or any products containing sugar from your meals or shopping list as much as possible.
• You should keep your meals portions and the amount of exercise you do at a controlled level. Remember that you need to expend more energy to burn the food you consume.
• Try to quit your unhealthy eating habits such as overeating, binge eating. Determine a portion for yourself and end your meal with this portion whether you are full or not. If you wish, you can consume yogurt, a certain amount of fruit or similar foods as a snack.
• If you smoke, you should quit before the surgery. Smoking not only creates complications by making it difficult for your postoperative wounds to heal, but also directly affects your stomach, causing you to gain weight.
• After you apply for bariatric surgery, your dietitian will create a list for you. Be careful to follow this list to the word.
• Alcohol both causes weight gain with the calories it contains and makes digestion difficult by affecting your stomach. Therefore, you need to eliminate alcohol from your life.
• Do not drink any beverages with your meals.

What to Eat Before Obesity Surgery?

You should consume only low-calorie but high-protein foods. As your surgery date approaches, you should start feeding yourself with more liquids.

Drinking protein powder and shakes will help you with this. Some examples of solid food your can consume are apple, banana, peach, apricot, pear, pineapple, melon, spinach, carrot, summer squash, green beans, yogurt, cottage cheese, lean beef, chicken, turkey, white fish and eggs.

Then, when you switch to a liquid diet, you can have decaffeinated coffee and tea, skimmed milk, thinly prepared soup and broth, unsweetened fruit juices (water with no extra sugar added, only the sugar of the fruit) and plenty of water.

Between the two orders, you should consume pureed food by making your food liquids with the help of a blender.

What Shouldn’t I Eat Before Obesity Surgery?

Foods that you must avoid before bariatric surgery ;

• High-sugar foods: Soda, sweets, chocolates, or all foods that contain high levels of sugar
• Alcohol: You must avoid drinking alcohol before the surgery.
• Fatty foods: Fatty meat, fried food, whole milk or meals cooked with plenty of oil should not be eaten.
• Fastfood: You should avoid all fastfood foods that contain saturated fat and unhealthy foods.

A Few Dietary Examples

For an example of a simple and functional diet;

• Day 1: 2 boiled eggs for breakfast, protein powder for a breakfast-lunch snack, boiled chicken for lunch (cut into very small pieces), yogurt for a snack between meals, baked chicken or lean meat for dinner, boiled vegetables.
• Day 1: Protein powder for breakfast, grilled chicken for lunch, a plain salad (lettuce, cucumber, onion, tomato), a small amount of salad dressing, high protein powder mix for snack, gravy soup for dinner, yogurt for evening snack.
• Day 1: Avocado for breakfast, 1 boiled egg, boiled vegetables, snack protein powder, lunch turkey meat and 1 slice of cheese, dinner 1 apple and some peanut butter, natural made ice cream for snack.

The diet you can apply for a completely liquid diet;

Breakfast; low-fat milk, snack protein powder;

Lunch; pudding and multivitamin, snack calcium powder;

Dinner; soup and liquefied vegetable stew, yogurt for a snack.

General anesthesia is applied to patients during gastric sleeve surgery. In accordance with the procedure, the stomach is arranged and the excess parts are removed from the body. At the end of the procedure, patients are kept under observation in the hospital for a few days.

Is a catheter used for weight loss surgery?The answer depends on your doctor’s decision as they will make the most appropriate choice for your situation during and after the surgery.

When Is a Catheter Used?

The catheter is usually used for patients who cannot move after surgery. Since patients do not have the power or sense to go to the toilet, a catheter is used to prevent patients from encountering unpleasant situations.

In cases such as your post-operative condition, encountering different complications during the operation, and urinary bladder dysfunction, your doctor will perform the catheter set after the operation.

Will My Doctor Use a catheter After My Gastric Sleeve Surgery?

After sleeve gastrectomy surgery, patients usually recover within 2 to 3 hours. In order to prevent pain, pain relief supplements are applied under appropriate conditions.

Depending on your weight and the severity of your surgery, and your existing mobility, your doctor may decide to insert a catheter. However, in a normal gastric sleeve surgery, the probe is not applied.

Probes are avoided so that patients are more comfortable moving and meeting their own needs, and can adapt to daily life more easily.

The Side Effects of Using a Catheter

Using a probe does not cause serious harm to people. However, you might feel a burning sensation during urination or other times because of the irritation in the urinary tract caused by the catheter set.

The balloon, which keeps the urinary catheter in place, has a low probability of bursting. In this case, the probe may not be able to perform its function, causing negative situations to occur.

Bleeding may be seen in your urinary tract caused by the catheter set. However, this bleeding situation will stop on its own. There is also a very low chance that the probe will infect which is why necessary cleaning procedures are performed before insertion of the probe.

Consult Your Doctor Before Surgery

If you have serious discomforts or problems with the insertion of a catheter after your sleeve gastrectomy surgery, you should share your question with your doctor before the surgery. It is possible for the doctors to make extra applications when they deem it necessary.

Since your doctor is the person who will take care of you the most during and after your surgery, sharing your concerns, fears, complaints, or problems with them will make the whole operation and post-operative process more successful.

What Conditions Cause Problems After Using a Catheter?

Patients usually do not encounter serious conditions after catheter use. People lose all the effects of the probe within a few hours to a few days. Urine and urinary tract return to their former healthy state.

However, in some cases, you should talk to the doctor. These situations are;

• The color of the urine turns red and does not lighten in the future;
• You encounter a foul-smelling discharge from your urethra;
• Increasing pain in the lower abdomen, high fever, chills, vomiting and nausea;
• In cases such as urinary incontinence or not feeling the urine of the person, it is necessary to consult a doctor.

Can I Prefer Probe Insertion?

The insertion of a catheter after sleeve gastrectomy is your doctor’s choice rather than yours. Your doctor will not provide catheter insertion unless necessary. If you have a request for a catheter to be inserted, your doctor may reject your request.

If you have a bad perception of inserting a catheter after your stomach surgery is completed, it is important to tell your doctor about this. Your doctor will stay away from the probe assembly until needed. However, in some necessary cases, the insertion of a probe may be inevitable.

What are the Causes of Catheter Insertion?

The main reasons for inserting a catheter after some sleeve gastrectomy or other surgeries are as follows;

• It is used after surgery for problems such as narrowing of the urinary canal, difficulty urinating or inability to urinate.
• If your urine needs to be followed, a catheter is inserted to facilitate regular urine color and content follow-up.
• If a urine sample is required for diagnostic purposes, a catheter can be used to avoid difficulties after surgery.
• If you have difficulty getting up after the surgery, if you have excessive pain or incisions that prevent you from moving, a probe set is performed.

Let’s read more about gastric sleeve, especially gastric sleeve in Turkey, and why it is a popular procedure among obese patients.

If you’re reading this article right now, you must have come a long way to decide whether you want to have weight loss surgery or not, and if yes, which type suits your situation the best. Gastric sleeve surgery is one of the most popular bariatric surgery types because it is effective but not as complicated as other medical procedures like gastric bypass. However, one of the biggest problems of these surgical procedures is their high price. Unfortunately, insurance companies sometimes do not cover all the costs since they are not always persuaded these surgeries are for the health of patients and assume they’re performed only for aesthetics.

As a result, many people who suffer from excess weight consider having a surgical procedure in other countries. This is a risky decision. When you’re living in the US or the UK, you just have to choose your surgeon. But that’s not the same when undergoing surgery overseas. You need a whole bunch of information about different factors affecting the success of your operation.

You should know:

-Is it safe to undergo gastric sleeve procedure in another country?

-What if your destination is really far? Is it safe to have a long journey?

-How much is the financial difference?

-Except for your surgery cost, Is there any other hidden cost? How much should you pay for tickets, accommodation, transportation, and hospital fee? e Is it wise to look for surgery at an affordable cost?

Are you eligible to have a vertical sleeve gastrectomy abroad?

Obviously, you cannot decide unless you find the answers to these questions. Moreover, even if your final decision is to have bariatric surgery in another country, options for medical tourism are not limited at all. In this article, we’ll find out if Turkey is a good destination for medical tourism and try to answer all your questions as much as possible.

Do not hesitate to leave a message if any of your concerns have not been responded to by the end of the article.

Turkey has been a popular destination for medical tourists. A noticeable amount of these people travel to have weight loss surgery Turkey. But this is just a claim. Let’s check some statistics to examine the credibility of this claim.

Facts about Medical Tourism in Turkey

In this blog post, we’ll give you accurate information about gastric sleeve in Turkey including:

– Differences between gastric sleeve in Turkey and other parts of the world

– Advantages and disadvantages of gastric sleeve in Turkey

– Who qualifies for sleeve gastrectomy in Turkey

– Gastric sleeve cost in Turkey and other parts of the world

– Travel requirements for Turkey

Is Gastric Sleeve in Turkey Different from Other Countries?

Gastric sleeve in Turkey is performed using methods as same as the ones in the US and the UK (mostly laparoscopic procedure). The main result of this effective surgery is the reduction of the patient’s stomach. Therefore, food intake will be less than before.

It is performed using both endoscopic and laparoscopic methods, but the latter is more common in Turkey. So, there won’t be any big scars, just some small incisions on the abdominal areas.

As most gastric sleeve surgeries all around the world, during the process of this surgical weight-loss method, about 75 to 80% of patients’ stomach is removed. This is done during a general state of anesthesia.

Moreover, gastric sleeve expedites excess weight loss by making hormonal changes. How? Hunger hormone is produced exactly in the part that is removed during surgery. So, patients feel full sooner and for a much longer time. This removed part is not just the one that controls your appetite but is able to stretch.

The reduction in food intake alongside these hormonal changes also helps eliminate obesity-related health problems, including sleep apnea and high blood pressure. This is all that happens to you after undergoing gastric sleeve in Turkey.

Why Do People Go to Turkey for Gastric Sleeve?

• Affordable prices (in comparison with the US and the UK) in addition to high-quality medical technology
• World-renowned achievements of Turkish physicians
• The combination of tourism experience and health services for both patients and their families
• Turkish spa and thermal centers
• No waiting lists
• High-quality clinics and hospitals
• Exceptional medical care in addition including attention to patient safety, foreign patients in particular
• Due to the progress of tourism in Turkey as its main industry, there are hundreds of luxury, comfortable hotels for your accommodation before and after the surgical treatment
• Patients will be thoroughly examined and their health will be evaluated before going back to their countries. Following surgery, you will be evaluated by professionals and given nutritional guidance before returning to your home country

I guess you’re thinking the right question is why not? All of the above-mentioned reasons gave Turkey a new reputation: Health Tourism Turkey.

Every year hundreds of obese patients from the USA, Greece, China, Germany, Spain, Japan, Egypt, England, Italy, France, South Africa, Belgium, Holland, Russia, United Arab Emirates, and many other countries come to Turkey for different types of surgery, among which gastric sleeve in Turkey is one of the most popular surgery types.

Disadvantages of Gastric Sleeve in Turkey

• Not knowing the Turkish language may cause you some problems when communicating with some staff or people in the streets.
• Not being close to home increases your need for a companion. So, bringing another person might be an extra cost.
• Checking specialist surgeons’ credibility is a bit difficult. And of course, options are not limited.
• Not being able to have face to face follow-up sessions with your surgeon and their team

These disadvantages might make you a bit worried about coming to Turkey for weight loss surgery, and you’re right to be worried. But, medical teams in Turkey have thought about these problems and solutions have been provided.

1- Not Knowing Turkish Is Not a Barrier

If you do not know Turkish, don’t worry at all. Most centers, including ours, have dedicated translators that speak both your language and Turkish fluently. They will be with you from the time you arrive at Turkey, during your consultation sessions with your surgeon and their team, and after the operation when you’re all packed to return home.

2- Look for a Cost-Effective Gastric Sleeve Package

Due to the high demand for medical tourism, most clinics offer patients all-inclusive packages that the actual surgery fees is only a part of it. Other costs are dedicated to accommodation, airport transfers, and transportation with no extra money for your companion.

We strongly suggest our patients bring a close friend or family member to be with them during the whole process.

3- Do a Thorough Online Research

Check all sections of your surgeon’s website. Read all the verified reviews and take a close look at all their previously performed bariatric procedure before and after photos.

Share all your concerns with their patient coordinator. Ask everything that comes to your mind. If they’re telling the truth, you’ll find it out.

And you can always find the patients that left reviews. See if they’re willing to talk to you and ask more questions about their experience.

4- Find a Surgeon with 24/7 Post-Operation Services

It is better to have follow-up sessions with your surgeon, dietitian, and psychiatrist for 1 to 2 years after your surgery. Due to the importance of these sessions, most surgeons give you appointment times to meet with you online.

During these questions, your dietitian might also be present to check your diet progress and make any changes in your schedule, if necessary.

For instance, at our center, patients can be in contact with their dietitian, bariatric surgeon (Dr. Ceyhun Aydoğan), and their psychiatrist for up to one year. Still, finding the best bariatric surgeons in Turkey is not that easy.

Gastric Sleeve Surgeons in Turkey

While you’re doing the research to find the best gastric sleeve surgeon at an affordable price, you have to pay attention to a few points in order not to get tricked. This surgery is vital to your health. So, you must be very careful.

If you want to know who is eligible to perform gastric sleeve in Turkey, beware that any surgeon who has completed the 5-year of general surgery studies is permitted by the law to do gastric sleeve surgery. But the question you should ask is that is this enough?

According to a study that observed bariatric surgery hospital complication rates in Michigan, the rate of serious risks during and after bariatric surgery is directly related to the experience of your doctor and how many surgeries they have done before.

For example, a doctor who is a medical specialist from a center where bariatric surgery is not performed during the general surgery assistantship attends three or four-day courses and tries to practice bariatric surgery, and unfortunately, many sad results are encountered as a result.

So, first, you need to make sure where your surgeon has passed their surgery assistantship. Was it in a hospital where bariatric surgery was frequently performed? Was he the assistant during these procedures? If yes, they’re one step closer to being your ideal surgeon.

Then, you have to ask your patient coordinator the approximate number of surgeries your surgeon has done before. This does not include the ones they were assisting, but the main surgeon. If they have a handful of experience both assisting and leading bariatric procedures, then you’ve found your surgeon.

Some surgeons, in America in particular, pass 2 to 3-day courses for bariatric surgery, but it’s not enough. When it comes to operation, nothing is as necessary as experience.

Gastric Sleeve Hospitals in Turkey

Bariatric surgery cannot be performed in any hospital as it is a very sensitive and special operation. Therefore, you must find out the suitability of your surgeon’s hospital for operation.

– The operation room must have certain equipment, international standards (ISO international standards), and medical facility.

– The score of the hospital’s intensive care unit must be at least grade 2. You can ask the name of the hospital and check its qualifications.

– The number of intensive care beds must be sufficient.

– In addition to your surgeon and their team, it is better there should be full-time physicians at the hospital, especially experts in the cardiology department. Make sure to ask about this and also check it for yourself.

– It would be better if there’s interventional radiology as well.

– Operating table and patient beds should be suitable for obese patients.

– You might have to stay 1 or 2 days in the hospital. Make sure it has enough facilities for you and your companion.

Equipment for Weight Loss Surgery in Turkey

One of the important factors that determine the cost of gastric sleeve is the type of equipment used in the operation. The variety of products in the market makes patients confused. American companies are among the highest quality products currently on the market and are more expensive than Chinese products.

However, safety is more important than cost. You are saving lots of money by coming to Turkey for surgery. So, just go on with the best procedure in Turkey and forget about the little difference in cost.

Who Qualifies for Gastric Sleeve in Turkey?

The process of bariatric surgery in Turkey requires patients to firstly send their individual information such as height, weight, and medical history to the medical team.

Then pictures might be needed. Sometimes even an online session with the patient is necessary.

After consultation, the surgeon will decide which type of surgery is better for each patient and if they agree, they will come to Turkey.

So, candidates for gastric sleeve operation in Turkey must tick all the necessary boxes for gastric sleeve in any other parts of the world such as:

1- Age between 18 and 65

2- BMI over 40 (over 35 for patients with serious morbid obesity-related health problems)

3- Psychological readiness

4- Patients who are willing to undergo weight-loss surgery, but having a long procedure like gastric bypass is risky for them.

5- Ready to change lifetime commitment to a healthy lifestyle

6- The most important requirement for international patients who want to undergo weight loss surgery in Turkey is the ability to travel to Turkey. We will discuss this in the next section in detail.

Gastric Sleeve in Major Cities of Turkey

Istanbul, Antalya, and Izmir are the three most popular cities for bariatric surgery. Let’s compare these three cities to see which one acts overall better

Just find what matters to you and then you can pick the right city for your surgery. For instance, if you prefer to have your operation in a modern clinic, there are a lot of quality private hospitals in Istanbul. So, you’d better find a surgeon from this city to perform your surgery in a private clinic or a private hospital.

Gastric Sleeve Turkey Price vs Other Countries

As might know by now, there is a noticeable difference in bariatric surgery cost, which depends on various factors including the type of surgery, the expertise of your surgeon, the country in which you want to have surgery, and many other factors. We’ve compiled all the information regarding weight-loss surgery costs in a separate article.

Here’s an overview of the cost of sleeve gastrectomy surgery in 11 countries, including North America, Europe, and Turkey.

As you can see, among the 11 countries we’ve gone through, the cost of gastric sleeve in the US is the highest, which is on average 18,000 €. In the UK, people must pay about 10,000 € and in the United Arab Emirates, almost 8,000€. In some other countries, like the Czech Republic and Mexico where gastric sleeve surgery cost is about 4,800 €, prices are less than other regions, especially Poland and Germany where prices are between 6,000 to 7,000 €. But still, sleeve gastrectomy in Turkey costs the lowest, about 3,500 € and it makes sense as the expenses and overall cost of living in Turkey is less than the other countries mentioned in the chat above. Also, this is not solely the cost of the actual surgery but medical gastric sleeve mdical packages that include transportation, patients’ accommodation, hotel stay, translation, and so on.

Requirements for Traveling to Turkey

Citizens of Which Countries Do Not Need a Visa to Visit Turkey?

Citizens of about 70 countries do not need visas to visit Turkey and can travel to this country just with their passports. However, the permitted duration of their stay differs.

Citizens of the below-mentioned countries can stay in Turkey for 90 days per visit and 90 days during a 180-day period.

Russian citizens can stay for 60 days per visit and 90 days during a 180-day period.

Citizens of the following countries can stay for 30 days during each visit to Turkey and 90 days overall during a 180-day period.

Citizens of Which Countries Need to Get an E-visa to Turkey?

Citizens of some countries such as Canada and the United States need to get a visa before coming to Turkey, which is really easy. Just got to the e-visa website and fill out the form. You should only pay a few dollars and the process won’t take up more than 15 minutes of your time.

Also, if you’re not sure whether you need an e-visa to enter Turkey, you can check this page and find your country in their list.

COVID-19 Travel Restrictions

For the time being, Turkey is open to travelers from all nationalities who follow travel rules regarding the special COVID situation.

If you have a valid passport and visa, you should check out the latest lockdown updates as international changes affect Turkey travel restrictions.

Gastric Sleeve Turkey Reviews

Nothing is more helpful than the real experiences of the people who have undergone gastric sleeve in Turkey. I have added some of the reviews of my previous patients+ their before/after images in the next two sections. This might help you decide better.

1- Nathan, Birmingham

“I’ve been overweight since I was 13 and now I’m, which means almost d 20 years of non-stop dieting, losing weight, and gaining twice as much.

I had sleep apnea and constantly felt depressed… I just wanted to be healthy. So, I considered bariatric surgery after gaining 21 pounds during the 7-month mark of the pandemic. So, I’ve been to Turkey 3 times for vacation and met with beautiful people whom I’m really grateful for. In November 2020 I contacted one of my Turkish friends and shared my intention of undergoing bariatric surgery. Fast forward to today; Here I am in Istanbul on my 3rd postoperative day and I’m happily recovering from my gastric sleeve surgery, with little pain, almost no complications except for a bit of nausea only one or 2-hours a day, which is normal 🙂 I would like to thank my surgeon Dr. Ceyhun and his professional team.”

2- Sarah, Texas

“I had gastric sleeve surgery performed by Dr. Ceyhun Aydoğan in December 2020. 6 months on I have lost 25 kg (my before surgery was weight being 243 lb) but am still working to reach my goal of losing up to another 25 kg. Once again I would like to thank my bariatric surgeon Dr. Ceyhun, my dietician Ms.Billur, the nurses, and the rest of the staff.”

3- Avery. J, Colodaro

“Back home I had worked together with a professional nutritionist and a personal trainer but hadn’t been able to maintain the weight loss, with the amount lost never being enough to help with my deteriorating health issues. I have been to Turkey (Antalya & Marmaris) many times for vacation, so when a family relative told me about her recent cosmetic surgery experience in Istanbul and how good the healthcare services, as well as the prices, were, I decided to do some research on the medical travel agency she recommended. My initial contact was with Merwe who was efficient at responding to all my inquiries. After sending in all the required information he asked from me including my BMI, medical history, previous operations undergone (if any), medication, etc. I was told that I was eligible to undergo bariatric surgery. Dr. Ceyhun explained all the fundamentals in great detail and provided me with all the preoperative instructions, including a special diet that I was advised to follow 2 weeks prior to my surgery. I will be traveling for my gastric sleeve operation on the 26th of December. I’m feeling nervous and excited at the same time but I am confident that the reassurance provided by Dr. Ceyhun and the team of Arpanu Medical will be making the whole journey worthwhile!”

Gastric Sleeve Turkey Before/After Pictures

Final Advice

If it’s possible for you, try to make the most of this trip. Just a few days off earlier than your surgery date, book a tour and immerse yourself in Turkey’s diverse and heterogeneous culture. Let this critical point of your life also be a memorable one.

Also, if you still have doubts about bariatric surgery costs, take a look at the previous chapter.

In the previous chapters, we covered diet, risks after weight loss surgery, the most common types of bariatric surgery, and all the basic information about this topic. However, you’re not ready to make the final decision yet because one piece is still missing: bariatric surgery cost.It usually takes a particular period of time, in some cases 1 to 3 years, from the moment you start considering weight loss surgery and to the actual time of the bariatric operation as it is a serious, life-changing decision that affects the rest of your life, thus requiring a lot of research.You have to gather a lot of information and process them in order to be able to make up your mind whether to undergo weight loss surgery and if yes, which weight loss surgery options are the most responsive ones according to your specific circumstances.One of the most significant concerns patients have during the research process is the exact amount of bariatric surgery cost, which is not a surprising fact as Gastric bypass surgery and gastric sleeve are among the 20 most expensive surgeries one can get.To be able to make the right decision you have to know:- The factors that affect bariatric surgery cost- What sections cost of surgery includes- Whether insurance covers it or not- The ways you can have safe, secure, yet affordable surgery with a skilled bariatric surgeon

What Affects the Cost of Bariatric Surgery

If you start searching the price for applicants of different types of bariatric surgery on the internet, you’ll find the results pretty shocking as not only do the costs differ worldwide, but you’ll see a wide range of medical expenses inside one country as well.Before jumping to any conclusion and choose a place and surgeon, you should know the causes for this variety.

1- Type of weight loss procedure

As you’ve read in our previous chapter on the basics of bariatric surgery, there are several types of weight loss surgery that will help you overcome morbid obesity. In addition to their procedures, they differ in costs as well.Gastric band, gastric bypass, and vertical sleeve gastrectomy are the three most popular operations among obese patients, among which gastric bypass is the most expensive one.

2- Your Bariatric Surgeon

Depending on their location, expertise, weight loss surgery experience, and the complexity of the operation type you choose, the fees you have to pay to your surgeon differ.

3- The Hospital or Clinic You Choose

Even if your surgeon performs operations in more than one hospital, as the fees that hospitals ask for vary, you should pay attention to this point as well.

4- Additional Expenses

Apart from your surgeon’s fee and the hospital billing, there might be some additional costs. This money is usually paid for:- Surgical assistant- Consultation fee- Anesthesiologist- Devices- Follow-up sessions and dietitian visitsSome medical centers offer packages to bariatric patients. Before going for one of these packages, make sure to know all the details and all the sections the overall package covers.

Before and After Surgery Costs

Your expenses do not limit to the actual surgery itself. In other words, your weight loss journey starts way before the operation itself and of course continues for the rest of your life.

Costs Before Surgery

First of all, if you choose a surgeon and place further than your location, you need to put some money aside for transportation.However, some surgeons, even the ones that are not in the same country as yours, are able to handle the consultations online. So, this expense will be eliminated that way.Your pre-operation healthy diet requires buying and preparing specific materials and supplements that you might not usually buy. However, depending on your previous eating habits, you might be paying even less on food because now there is a plan that you can eat based on.Before the surgical procedure, you should start working out. Some people prefer to work with a professional coach, which requires spending a lot of money. However, you don’t need to do any special types of physical activities in order to lose some weight before the operation.You can simply lose some extra weight by doing simple activities like walking on a daily basis. It’s not the complexity of exercise that matters, but its consistency.

Costs for Life After Surgery

The changes you have to make might have started sometime before surgery but continue not only till surgery recovery but for the following years as well.  For instance, your diet program changes forever not just for months after surgery.You need nutritional supplements including vitamins and in some cases, protein shakes and just for a few weeks after surgery but for the rest of your life.Some people prefer having a gym membership as it gives them a sense of necessity and obligation in addition to a regular exercise program. However, you can train yourself to be active even without a gym membership. Thanks to the internet, you can stay active at home using quality videos by proficient coaches at any level.Be aware that in case you want to add up to the difficulty of your exercise, change your activity after wounds are healed to a great degree.As you lose weight and your health risks decrease, you become a more outgoing person. Well, going out does not necessarily mean spending more money. There are tons of outdoor, free activities you can take in.Your new appearance needs new clothes! Well, even though it is extra money you have to pay, it is a pleasant one, isn’t it?

Does My Health Insurance Pay for My Healthcare Expenses?

The truth is that insurance coverage varies depending on different factors. It is all related to your insurance company, the type of insurance plan, and of course your doctor. But if they accept to pay for your surgery, they should pay for the majority of costs, if not all.Some insurers consider overweight people as high-risk patients as they are at a higher risk of harsh health comorbidities including type 2 diabetes, coronary heart disease, obstructive sleep apnea, and high cholesterol.However, some insurance companies believe obesity can be solved through nonsurgical treatments and obesity medicine. So, they won’t pay for the stomach surgery and its hospital costs.

How to Get Your Insurance Company to Pay for Your Surgery

Here’s a 4-step guide to convince your insurance company to pay for your surgery. Here’s a detailed explanation of how the insurance coverage process for bariatric surgery works in the US.First of all, you have to tick the boxes below:- BMI over 40or- BMI over 35 and one of the following complications:

• Obstructive sleep apnea
• Coronary heart disease
• Medically refractory hypertension
• Type 2 diabetes
• Otherobesity-related health issues

If you’re looking for a fast process, unfortunately, insurance is not the right option because even if you have the above-mentioned conditions, you should complete a 3- to 7-month supervised diet program. The aim of this process. This is to make sure you cannot get to your healthy weight without surgery.The next step is to arrange a consultation session with your bariatric doctor.Afterward, you should schedule a consultation with your care physician and get a medical clearance letter.Then, the last document you need is an evaluation from a registered dietitian.Finally, you should send all these documents alongside your medical history and challenges in nonsurgical attempts.The insurance reviews your documents, which usually takes approximately one month. Then, they will inform you whether your application was rejected or approved.However, even if your insurance company still does not pay for the operation, don’t worry. Where there’s a will, there is always a way.

Medical Travel, an Affordable Alternative

As we’ve mentioned before, the expenses weight loss surgery patients have to pay vary depending on the surgeon’s fees and location.Here’s a comparison of the average cost of different types of bariatric procedures in five countries.

Medical Travel Benefits

If you’re considering medical tourism, it’d be better if you knew its benefits as well.

– Affordability and cost-effectiveness- Reasonable prices of international travels- Travel opportunities- Immediate service- Improvements in global standards of healthcare and bariatric care- Easier communications than before

Costs of Obesity vs. Costs of Stomach Surgery

If you’ve done complete research, yet still think it is not worth paying this money to get rid of your excess weight, you’d better revise your decision just by taking a look at the cost of obesity.Staying neutral and taking no actions to resolve obesity just increases your health issues including high blood pressure, cardiovascular disease, different types of cancer, high mortality rate, type 2 diabetes, gallbladder disease, kidney and liver disease, and many other risks of complications that affect your overall health conditions.According to the Centers for Disease Control and Prevention, the overall cost of medical care related to complications caused by obesity was about $147 billion in 2008. Unfortunately, as adult obesity rates increases, this number also rises every day.Even if you’re so lucky that have not experienced these difficulties yet, still you have to pay money on regular tests and obesity screening to make sure everything is OK.Moreover, if you’re willing to get your health back by nonsurgical solutions, you should know that cost of weight loss through these methods is even more in the long run. Also, even in successful cases, most of these methods lose their effectiveness after some time.

Wrap It up

Whether you’re certain about the type of your surgery or not, it’d be better to take a quick look at chapter 3. Also, chapter 5 includes a complete guide on weight loss surgery in Turkey, one of the current most popular places among obese patients.

There’s only one chapter left till you can make the best decision for the rest of your life. Let’s check the final chapter of your bariatric journey.

No matter which type of weight loss surgery you underwent, caloric intake decreases drastically. But how many calories should I eat after gastric sleeve surgery? If you or your loved one went through gastric sleeve surgery, then you should brace yourself for the new style of life. The real challenge starts the day you are awakened after surgery. 

An average of 1200 calories after gastric sleeve is the limit for your daily intake. That is of course three months after surgery. In the early stages, 300-600 calories per day for your body to adjust to the new environment.  

To achieve your weight loss goals, you should say your last goodbyes to artificial sugary snacks and oils. Instead, you will be doing math problems, counting your macronutrient intake, as well as fluid intake.

What should my macros be after gastric sleeve?

Micronutrients are the most three substances you digest on daily bases; fat, protein, and carbohydrates. These three units are basically calories. Arrange your meals to have 50% protein, 30% fat, and 20% carbs. That way half of your calories will be divided into carbs and fat and the other half is protein.

Fibers are your bestie, it is a common issue for bariatric patients to go through constipation. Therefore, try to include fibers in your diet. It eases the business in the bathroom. But adding too much fiber suddenly in your meals will not be in favor of the stitches of your bariatric procedure. Start with 15 grams of fiber, then go for more if you face issues like feeling bloated.

How many carbs should I eat after gastric sleeve?

Follow a diet that lacks bad carbs like artificial sugars and instead stick to healthy fibers. Generally, 125-140 grams of carbohydrates should be taken on daily bases.

Speaking of bad guys, having high levels of glycaemic index (GI) in food effects negatively on body. Your sugar level in the blood will be like if someone hit the hammer on the high striker game. In other words, glucose levels will rapidly increase after GI foods.

The scale of carbs take changes with time, after half a year of the surgery, you will be able to consume about 1200-1400 calories daily. It is ranged into three meals a day like a normal daily food routine. That is the goal you should be able to stay in, not less or more.

This table shows the number of carbs you should take per day cording to months 1, 3, 6, and 12.

	Baseline(AVG)	Month1	Month3	Month6	Month12
Carbohydrates %	39-51%	35-49%	34-52%	37-54%	40-53%
Grams per Day	220	87	102	109	140

How many grams of protein after gastric sleeve?

There are special protein powders for bariatric patients to consume protein in liquid from in early stages. The average amount you should set your goals for is around 60-70 grams of protein. It will be challenging in the early stages but later on, you will be able to consume the needed amount. 

Getting protein supplements will make you gain more muscle tissue. Once you’re back on your feet, try having soft cardio walks or physical activity to help burn fat and take advantage of loaded protein to muscle tissues. 

In that case, you will help to lose the unwanted extra weight and then look good, confident, and most importantly mentally happy.

How many grams of fat per day after gastric sleeve?

Just because you’re trying to lose your excess weight, it doesn’t mean you have to cut fat 100%. You should always balance your intake. But also, if fat intake is more than protein or carbs, it will be unhelpful to reach the goal of losing weight.

For instance, avocado and nuts would be good sources of healthy fat, especially for the heart. It is also very nutritious, low in carbs, and high in fiber.

Here is a table to follow how many grams of fat per day after sleeve gastrectomy surgery:

	Baseline(AVG)	Month 1	Month 3	Month 6	Month 12
FAT Content %	27-39%	23-43%	29-39%	29-41%	29-34%
Grams per Day	72	28	38	40	45

Also, choosing the correct sort of fat is important, you shouldn’t go for fried or greased substances. That is the enemy or a beautiful lie we all should prevent. They are high in bad calories and they are certainly not nutritious fats.

How much water a day gastric sleeve?

The importance of staying hydrated after gastric sleeve surgery is life lasting routine. You should take in 67.6 oz (2 liters) of water per day. It may be a lot in the early days, but that’s fine. Once you can handle taking in more cups of fluid, reach for the bottle of water more often. 

It might even be hard enough to sip water in the early days, it is very typical for bariatric surgery patients, and tiredness will be heavy on your shoulders. When your stomach stitches are healing over time, it’s easier to hydrate yourself with plenty of water and clear fluids. Your organs will be thanking you for the blessings, especially the livers.

Keep in mind that your stomach is way smaller than it used to be after surgery, therefore, make sure you also do not take large sips of water at once. That will be too heavy on your unhealed stomach.

But what if I do not drink enough water? Well, after gastric sleeve surgery, the doctor recommends hydration every now and then to avoid many symptoms like:

• UTI: Urinary tract infection is one of the most common things that may be seen in bariatric post-op.  
• Constipation: Dehydration can make your number 2 business hard in the bathroom. Always keep water next to you.

How often should you eat after gastric sleeve?

It’s not only about “how many calories should I eat after gastric sleeve,” you must divide your calories in pieces, too. This is the main point of this whole journey, and this goes in gradual stages, here is how your post-op diet should be:

In the early stages, it is between 5-6 meals per day. It’s all liquid meals and nothing else. You will have the 3 main meals and snacks, liquid of course.

When you first wake up, it will be hard enough even to take 3 tablespoons of fluids, but over time things will become smoother. In the first 3 weeks, your daily servings are only clear fluids that have no bits or soft pieces. That is a very critical period of time for your stomach to welcome any guests. Chicken broth for instance is a good early guest.

Once you start having soft foods in your diet like mashed potatoes, you will be doing 4 meals per day, each meal should be less than a full cup. After 30-40 days of surgery, your meals will be 3 per day. Also, your diet changes to more fun food such as cooked vegetables, eggs, fish, or lean meat. But do not count ice cream as soft foods or creamy, that is something we are trying to avoid in our bodies after bariatric surgery.

What should be my portion size after gastric sleeve?

The choice of food is very important after bariatric surgery, you can’t eat much and feel full fast. So, you eat the nutrition needed. Generally, your surgical team gives you a program to follow and you should stick to it.

First of all, you should always prioritize your protein shake for daily doses. Here is a general idea of how much food to take during the day and month:

For the broths, drink 200 ml and 1.5-2 liters of water daily. This is in the early days because it’s all fluids.

Then you go to a phase of eating pureed food, you have about 3 ounces of the meal. It should cover numerous and enough protein for each meal in a day.

Once you’re able to eat soft foods, have 1 ounce of boiled egg or canned tuna per meal. Or you can eat 1/4 cup of well-cooked, pureed vegetables. Or if you feel fruity, you can eat the same portion but as long as it is soft fresh fruits/canned fruits, but not fruits with skin.

You can use appetizer plates to arrange your portions. Half of it will be protein, and half of the rest will be carbs and fat. Also, having a small plate will satisfy your eyes and you won’t feel like you’re eating small portions. 

References: 

(1) Vinolas H, Barnetche T, Ferrandi G, et al. Oral Hydration, Food Intake, and Nutritional Status Before and After Bariatric Surgery. Obes Surg. 2019;29(9):2896-2903. doi:10.1007/s11695-019-03928-y

(2) Helmen ZM, Helm MC, Helm JH, et al. Predictors of Postoperative Urinary Tract Infection After Bariatric Surgery. Obes Surg. 2018;28(7):1950-1954. doi:10.1007/s11695-017-3095-6

What is a better fit for you, mini gastric bypass or gastric bypass? This article will give you a hint of which is a safer procedure for you. Both metabolic surgeries help improve your BMI to a healthier range. However, each one has a different approach from many angles for a reason, each one serves a specific type of patient to avoid unneeded complications. 

It all comes down to your motivation for the surgery, your health background, and breaking it down with your doctor to come to a conclusion for the best solution to your condition.

The ultimate comparison: mini gastric bypass vs. gastric bypass

The comparison between mini gastric bypass vs gastric bypass is widely ranged despite their relatively in name and purpose. Surgically, risks, post-op care, and depth of goals take two paths for each weight loss surgery. Yet they both relate to losing weight procedures and fixing complications of obesity.

Surgically they differ anatomically, and in way of bypassing intestines, and punch size. That plays a role in how each one differs in food portion intake and the surgical risks behind each one.

When it comes to related connections between each type of weight loss surgery, they have slightly different requirements but they both aim to lose almost the same percentage of weight which is around 50 to 70%. Losing weight automatically connects to improving heart problems, sugar levels, and other obesity-related diseases.

The anatomy of each procedure

The study and valuation of each surgery differ in terms of gastrointestinal examination and other considered analyses. In conclusion, there are different approaches and audiences for each one to serve the patients’ needs with proper delivery.

Here is a table explaining the surgery operation differences between gastric bypass surgery vs mini bypass:

	GB	MGB
Stomach pouch size	1 oz.	3 oz.
Small intestine length	50-150 cm loop	180-200 cm loop
Number of anastomoses	2 connections	1 connection
Operation methods	open cut/laparoscopic	laparoscopic

Bypass operation has a smaller pouch than the mini version and that’s for less food intake which aims to have more affection on the excess weight. The intestine loop length also plays a role in how much your body absorbs calories and nutrition. Both of the surgeries are done laparoscopically but gastric bypass (aka GB) used to be performed with an open cut in the older days. Although the methods can be the same the connections in anastomoses differ because GB has pouch and duodenum connections to smaller intestines whereas mini gastric bypass (aka MGB) has only a pouch connection to the smaller intestine.

How they tackle obesity

Tackling obesity in mini gastric bypass vs roux-en-y has many similarities because they both improve the same obesity-related disease. Type 2 diabetes, sleep apnea, and high blood pressure are common health improvements among them. However, they differ in absorption and digestion proportion.

The calorie and food intake is a bit less with GB because MGB has a bigger gastric pouch size and intestine arrangement which cause less malabsorption. Therefore GB is more effective to lose weight in a shorter time than MGB.

Complication rates, benefits, and risks

The risk rates between gastric bypass vs mini gastric bypass differ widely due to surgery complexity. Thanks to modern and higher-quality equipment, the risks of bypass complications are minimal and the benefits overcome the risks. Here is a table that explains the possible complications and benefits of each bariatric surgery:

	Gastric bypass	Mini gastric bypass
Complications	Wound infectionsBleedingLeaksBowel obstructionHerniasNutrition deficienciesAcid reflux	NauseaVomitingAcid refluxUlcers
Benefits	Significant weight lossComorbidities improvementLong-term results	Significant weight lossFewer complication risksMore affordable

These complications are studied very well, therefore, with an experienced surgeon team and proper medical tools, the risks are minimal. Even if any of the complications occur post-op, recovery days are mandatory for detection, monitoring, and IV nutrition. Furthermore, you will be instructed to a certain lifestyle to maintain healthy and nutritious life, and accordingly, excess weight loss will be more possible. 

Differences in post-operative care

Postoperative care in the first day or two is generally similar in terms of the nursery between gastric bypass vs. mini gastric bypass surgery. Then it changes from many angles, here is how:

1. Gastric bypass patients might stay a day or 2 days longer in the hospital to recover from the surgery due to its complexity but mostly it’s 2-3 days for both types.
2. MGB patients have faster diet development to soft food and how many ounces of food they can tolerate in the long run.
3. Each type of surgery requires follow-up visits to check how your quality of life has changed and your overall medical condition. The number of visits may differ from one surgery or patient to another.
4. Minerals and supplements are important to both bariatric procedures because you will need to take iron, vitamin D, B12, and calcium. However, the amount and types of portions may differ according to the procedure.

Just like any other weight loss surgery you need to follow post-op instructions to avoid the risk of complications and maintain quality of life.

Second surgery possibilities

It is possible for both kinds of bypass surgeries to undergo a second surgery. Revisional surgery, in other words, is complicated and has different levels of invasiveness. However, mini-bypass patients have more chances and the ability to discuss a revision surgery than traditional bypass patients. This is because it holds more abdominal complexity examinations. 

Your surgeon will need to know if your problem is chronic or has already done damage like infections, bleeding, pouch enlarging, etc, and will see if your difficulties are solvable or not with a certain lifestyle or medication. If you face surgical complications, weight regain, or inadequate weight loss, undergoing an additional surgical procedure is necessary.

Weight loss duration and sustainability

Losing weight is assured and significant with both surgeries and both give great results in the first year. However, its sustainability of it is based on the consistency of following the diet and exercise instructions given from day one after surgery.

Does that mean that I can undergo either one and expect the best results? No, each one has its own health requirements, goals, surgical manners, and approaches. The answer for the best solution for your case to satisfy your needs is to discuss it with your doctor, they will determine the best approach for you. 

Choosing the right procedure for you: factors to consider

Think of it this way, gastric bypass is a major surgery and the mini version of it is a less invasive surgery and serves similar goals for less obese patients. So, gastric bypass requirements and mini bypass requirements slightly differ. Here is an eye-opener for the best for you based on factors and situational conditions:

Factors	GB	MGB
BMI	40+	30-35
Surgery period	2-7 days	2-3 days
Invasiveness	more	less
Supplemental need	required ✓	required ✓

Other than the factors considered, the surgeries are alike in terms of requirements in a way, and here is what you need to know:

1. Alongside the BMI, there are the same obesity-related diseases such as obstructive sleep apnea, type 2 diabetes, blood pressure, and heart disease.
2. Diet, meds, or exercise attempts that have failed without surgery.
3. Body free of alcohol or drug misuse and medical history.
4. Positive mental evaluation proving readiness for a new lifestyle for pre and post-op.

At the end of the day, the best choice of bariatric surgery for you will be based on tests and blood work, and other examinations. Let your doctor be the judge of what is best for you because that helps counter major complications. That helps to build the road for you to lower the excess body mass.

The pre gastric bypass diet is generally an optional 2-week diet that’s been prepared for patients who are scheduled to have the surgery. Some patients may be required to follow this diet so that they can lower their BMI and decrease the size of their liver, indirectly making the procedure easier and safer to perform in their cases.

The diet consists of 4 steps, regressing as the due date comes closer. Starting with step 1, there are foods you need to start avoiding such as processed, fried, or starchy food. Also, you need to start balancing your portions as instructed to get sufficient nutrients and reduce your fat and sugar intake. By the 4th stage, there will be more limitations to what you can consume as this is a regressive diet plan.

Although not absolutely necessary, a diet before gastric bypass surgery can only help with the post-op journey and improve the patient’s health. In this article, we will provide you with information about what to avoid and what to eat, its possible benefits, and what the stages look like.

What does pre op bypass diet look like?

The gastric bypass pre op diet plan looks a bit like the post op diet, except it has 4 steps, only takes 2-3 weeks, and regresses as the day of your surgery comes closer in food texture-wise. You start with solid food and switch to soft foods afterward. Finally, in the last few days before your surgery, you will switch to liquids.

Your calorie intake for this diet should be between 800–1200. However, there are other programs that were studied and were found effective for the pre-op diet. Such as VLCKD (very-low-calorie ketogenic diet) → VLCD (very low-calorie diet) → LCD (low-calorie diet). VLCKD and VLCD require a calorie intake of fewer than 800 while LCD requires between 1000–1400. VLCKD requires proper observation and care in order to get the full benefits of it and avoid any repercussions.

Disclaimer:You must consult a dietitian before following these programmes. They might not be suitable for your condition.×Dismiss this alert.

A nutritional guide to bypass pre op diet

If you are recommended to or you want to follow it, you should be doing early adjustments. For starters, you should increase your protein intake. Along with consuming high nutritional value foods, you should keep good track of your water intake.

During the pre gastric bypass diet, there are nutrition/foods to avoid such as caffeine, fast/fried food, simple carbohydrates, processed food, and carbonated beverages and/or sugary beverages. Instead of butter and margarine, you can use olive oil and other healthy fats such as avocadoes and nuts.

You can find sugar-free options for snacks that are as satisfying and delicious. For instance, a sugar-free fruit popsicle.

Below is the table where you can find your recommended macros and calories for diet before gastric bypass.

Calorie	Protein	Fat	Carbohydrate
800-1200 calories	60-100 grams	26-42 grams	50-100 grams

As you can see, there is a certain range to how much you need to consume. It does not matter which stage you are on, as long as you are in between the recommended macros, you are good to go. Just make sure you are not getting less nutrients or more than recommended.

So what are these stages and what do they look like? You will start with a solid diet which will last around a week. Afterward, you will move on to the 2nd stage, a soft diet. This stage will last shorter than the first, around 5-6 days. And finally, you will switch to a liquid diet for 2-3 days before your surgery. After all this is over, comes the 4th stage, which is the night before your surgery where you should focus on making sure your stomach is empty by the time of your surgery.

Solid diet – 2 weeks before

You should increase your protein intake to make your body prioritize burning fat instead of muscle. Along with that, increasing your consumption of high–fiber fruits and vegetables can help the food pass through the digestive tract easily and improve bowel movements.

During this stage, you should start to avoid:

• Simple carbohydrates such as white rice, white bread, pasta, etc.
• Processed food
• High-sugar foods and beverages
• High-fat foods
• Refined sugars
• Caffeinated beverages and carbonated drinks
• Excess alcohol consumption
• Binge eating

You can have decaf coffee, provided you are aware even though so little, it still has caffeine. So you should keep yourself hydrated since caffeine dehydrates the body.

Although, ideally you should stop smoking 1–1,5 months before your surgery. If it is hard to quit, try smoking less and stop 15 days before altogether. However, if you still can’t stop smoking, make sure you don’t smoke at least 12 hours before your surgery and avoid smoking for 3 months after your surgery.

Soft diet – 1 week before

You should stop consuming red meat like steaks and choose ground beef instead. You can still have lean meats provided you blend them and take your time chewing them. But it can be better to consume protein shakes to keep your protein intake up. For breakfast, you can have one boiled or scrambled egg. You should also stop consuming raw vegetables and steam or boil them to make them softer. Decrease your consumption of citrus fruits to help your stomach regulate acidic levels.

At this point, you need to start avoiding textures and foods, such as:

• Solid food
• Raw vegetables and fruits
• Citrus fruits
• Vegetables that can make you gassy
• Cooked/raw onion or garlic
• High-fat dairy
• Lactose milk
• Spices except for salt
• Coffee

Liquid diet – 2 days before

When you switch to liquids, make sure you get clear liquids into your system, except for protein shakes. This does not include clear alcoholic beverages, of course. As soon as you get to this stage, you should stop consuming alcohol altogether and avoid it for about 3 months after the surgery. You can have low–sodium broths (chicken, bone, or veggie), clear tea without milk, fresh and unsweetened juices, etc. A liquid diet before gastric bypass can help you brace yourself for the same one after gastric bypass.

Last two days, make sure to avoid the following:

• All kinds of dairy
• High-sodium broth
• Alcohol
• Dark tea
• Apple or grape juice
• Oils (olive, coconut, etc.)
• Sugary compote
• Sweeteners

The night before surgery

The day before your surgery, you should stop eating or drinking 10 hours before the surgery so that your stomach can be empty the following morning. And if your surgery is scheduled for late morning, noon, or afternoon, stop eating or drinking 2–3 hours before you plan to go to bed. Lying down to sleep on a full stomach can disrupt your sleep and can cause heartburn, indigestion, and acid reflux. Also, if your stomach is not empty before surgery, your surgeon may need to postpone the surgery.

Pre-op gastric bypass diet helps you with…

People do a pre gastric bypass diet for several reasons. The purpose of the pre-op diet is to reduce the size of the liver, which can make the surgery safer and easier to perform. The liver is located near the stomach and may be enlarged in overweight people, also known as “fatty liver disease”. This condition can make it difficult for surgeons to access the stomach during surgery. Patients can decrease the size of their liver and make their surgery less risky by following it.

The pre-operative diet may aid in weight loss prior to surgery, ultimately lowering the risk of postoperative complications during and after the procedure. Weight loss may have a positive impact on overall health and increase the chances of long-term weight loss success following surgery.

The pre-op diet can also help patients prepare for their life after the surgery. It can also help prepare the post-op one which is crucial for a successful recovery and long-term weight loss. To prepare for post-op changes, patients may follow a pre-op diet that involves consuming smaller portions, opting for healthier foods, and increasing protein intake.

Is it really necessary?

In some cases, some surgeons may ask their patients to follow this for 2-weeks to eliminate possible risks. Fatty liver can make it more difficult to retract from the stomach during surgery. As the BMI of patients surpasses 50, the associated risks also escalate. To avoid these from occurring, some patients may be recommended to follow this diet. Some surgeons also recommend it to all their patients, which is just a preference.

While optional, some patients may want to follow this dietary plan. Patients can follow this pre-op diet as long as they consult with their dietitians and ensure they are not depriving their bodies of essential nutrients, vitamins, and minerals. They can do it shorter for a week, or just liquids 2-3 days prior to surgery.

Other surgeons do not see the diet prior to gastric bypass as necessary. It will have little to no effect on the surgery, but the patient can follow it if they desire to. The use of advanced technology equipment, like a liver retractor, can make it easier to retract the liver from the stomach during a medical procedure, provided that the liver is not excessively fatty or stiff.