The last part of the small intestine is done by providing a second exit to the lower part of the stomach. In this way, the food that is eaten is passed through all segments of the small intestine. In this application, 100 or 120 cm is counted from the point where the small intestines meet with the large intestines, and this part is marked.
Preference between 100 and 120 cm is determined by patient characteristics. From this point, counting another 150 cm, the small intestine is cut from 250 cm from the junction of the small intestine with the large intestine.
The lower end of the cut is connected to the stomach. The upper end is connected to the 100th cm previously marked. The only important point is that approximately 1/3 of the food passes through the duodenum, which is a natural route, and 2/3 through the last part of the small intestine, thanks to the newly made connection.
How Does A Transit Bipartition Surgery Work?
First, a sleeve gastrectomy operation is performed. This requires a careful preliminary check to rule out the presence of inflammation or swelling. The liver, pancreas, and gallbladder are also examined. The procedure is performed under general anesthesia and takes about an hour. It is made in the form of a keyhole, which means that several incisions are made in the skin, about two centimeters in size, through which the camera and instruments are inserted. With the help of stapling device, most of the stomach is cut off and the resulting suture is simultaneously sutured. Only after this the actual transit bipartition begins, connecting the lower part of the small intestine with the lower part of the stomach. You must stay in the hospital for three to five days for follow-up checks.
What Are The Advantages Of Transit Bipartition?
- Low intragastric pressure and therefore no gastric leakage.
- Maintaining the sleeve size and preventing its expansion in the long term, also due to low intragastric pressure.
- Because it also reduces absorption, it promises greater weight loss effects than simple sleeve gastrectomy.
- Passage and absorption of food through the entire digestive system
- The hormonal thermostat mechanism has been corrected as the procedure restricts calorie intake and speeds up gastric emptying.
- The fullness of the small intestine can be achieved by endoscopic methods. This avoids the inaccessibility of the gallbladder, pancreas, and bile ducts, which is commonly seen in methods that shut off the duodenum. The duodenum and bile ducts can be reached with ERCP
- Preservation of the antrum, pylorus and duodenum eliminates the need for vitamin, mineral, iron and calcium supplementation after surgery
- The distance between the intestines can be adjusted according to the severity of the diabetes. The operation can be undone easily.
- This is a revision procedure that can be performed in a much more practical way than any other revision procedure, especially after a sleeve gastrectomy, after which weight recovery can be observed.
- Helps overcome the deficiencies of iron, vitamin D and vitamin B1 (thiamine) common in diabetics and especially obese diabetic patients who have never undergone surgery (% 8-19,% 32-60 and% 18-45, respectively).
Who Is Eligible For Transit Bipartition Surgery?
Transit bipartition surgery can be performed as a result of the following conditions:
- People must have TYPE 2 diabetes in order to undergo a surgery cannot be applied to patients with type 1 diabetes.
- Patients’ supply of insulin, that is, their ability to produce insulin, must be adequate. In some patients with type 2 diabetes, this reserve is zero or close to zero. In these cases, the transit bipartition operation cannot be performed.
- The body mass index of patients undergoing to transit bipartion operation should be thirty-five or lower. Obesity surgery is used to determine body mass index.
- Heart and lung health of patients who will be operated must meet minimum requirements.
- There should be no problems with liver and kidney function.
- Patients should not have wounds, ulcers, gastritis or similar diseases in the digestive system.
- Transit bipartition surgery does not apply to cancer patients, pregnant women, and new-born women.
Usually these are conditions for performing operations, but other conditions can be determined after a medical examination. In addition, if some of the conditions here are not met, the operation may be approved by a doctor. All diabetics are special and subject to special assessment. Patients with type 2 diabetes should definitely consult with a qualified doctor to see if they are suitable for surgery.
How Much Weight Can You Lose With Transit Bipartition Surgery?
Since this is a relatively new method, there are no long term results yet. However, you can already see that the chances of success are very high. You can lose from 33 to 83 percent of your overweight, and you can positively influence and regulate hormonal mechanisms in the long term.
Benefits of Transit Bipartition Surgery
Patients have been shown clinically to provide a large number of postoperative benefits.
- 85-90% of overweight is lost.
- Significant improvement in type 2 diabetes (85%), hypertension (90%), sleep apnea (75%), and hyperlipidemia (95%).
- Increased physical activity, productivity, well-being, economic opportunity and self-confidence.
- 10 years of persistent weight loss
- Short-term hospital stay due to closed operation
- Vitamin deficiencies are less common
Many diseases can improve or be completely cured after transit bipartition operation:
- Type 2 Diabetes (%85-90)
- Hypertension (>%90)
- Hyperlipidemia (%95)
- Sleep apnea (>%75)
After Gastric Transit Bipartition Surgery
- After surgery, patients are recovering for the first three months. At the same time, this is the period when new eating habits are formed.
- From the second month, the patient can return to social life and work that requires light effort.
- When diabetes begins to subside, its mobility increases significantly. Patients with increased mobility can travel or take longer walks.
- Eating habits are also starting to change for the better. The number of prohibited foods is gradually decreasing.
- If there is, excess weight and other metabolic problems caused by diabetes begin to disappear.
- Two years after the operation, there is no sign of diabetes. However, the patient should be given optimal attention to their eating habits so that they do not have to deal with diabetes again.
Life is very comfortable after surgical treatments for diabetes, especially after transit bipartition. The fact that the problems with obesity surgery do not arise is the main reason for this comfortable state. The patient does not need to take any vitamin or mineral supplements.
Transit Bipartition Surgery Diet, Nutrition, Eating Plan
After surgery, the patient receives a one-year nutrition plan. The diet is a low-calorie diet consisting of foods that are low in carbohydrates and high in protein. Also, the patient takes vitamin and mineral supplements. During the recovery period, the patient follows a liquid diet with high nutritional value. The patient needs to chew more to facilitate digestion. Coffee should be avoided for the first 2 months as coffee is bad for the stomach and causes swelling. Drinking alcohol should be avoided for 6 months. Carbonated drinks (sodas and mineral water) should be avoided for lifetime.
After surgery, you should avoid strenuous physical activity and sex for 1 month. The patient should not become pregnant within 1 month.
The doctor suggests exercises after surgery. Walking, swimming and fitness are suggested first. Abdominal exercises and weight lifting should be avoided for a specified time.
How Much Does A Transit Bipartition Surgery Cost?
Due to ethical rules of competition between institutions and awareness of internet pollution, our prices for transit bipartition operation are not listed on our website. Because our goal is to provide you with the highest quality and most accurate medical information and services. Thus, we can provide the necessary information about which medical operation will be the right choice for you. Contact us for details. Our consultants who are experts in their fields are ready to help you.
Prof. Dr. Alper Çelik
Related Medical Services.