Metabolic surgery procedures are performed using a laparoscopic (minimally invasive) method, providing a surgical treatment option for patients with obesity and type 2 diabetes. With this approach, our patients not only lose weight but also remain healthy without the need for insulin and medications.
For most patients, the process of discontinuing medications occurs within 3–5 days after surgery, although for some it may take up to 1 week or even 3–4 weeks. Of course, the key is not to operate on every obese and type 2 diabetic patient; with proper patient selection, individuals can stop using insulin and other medications, allowing them to live a freer life.
Although the concept of metabolic surgery technically refers to the surgical treatment of all metabolic diseases, in everyday practice it primarily means the surgical treatment of type 2 diabetes. Recently, one of the frequent questions we’ve encountered in the outpatient clinic is: “Is surgical treatment for diabetes possible?”
These surgeries have very high success rates in treating obesity and type 2 diabetes in appropriately selected patients. They also help resolve many additional problems that develop secondary to obesity, such as metabolic syndrome, insulin resistance, sleep apnea syndrome, hypertension, hyperlipidemia, mobility issues, gastroesophageal reflux disease, fatty liver, and even some cancers caused by obesity.
We Recommend Surgery for Type 2 Diabetes
Success is entirely dependent on proper patient selection. Not every patient is a candidate for surgery. First, the patient must have type 2 diabetes. This means we can expect good results if the person still has insulin-producing cells in their body. Our insulin-secreting organ is the pancreas, and it is essential that it retains a sufficient number of insulin-producing cells—a fact that is determined through preoperative tests. The second criterion is the body mass index (BMI). BMI is an indicator that helps us determine whether a person is obese, and it can be calculated simply by dividing one’s weight by the square of their height. For patients with a BMI over 40, for obese patients with a BMI between 35–40 who have additional problems (such as hypertension, hyperlipidemia, metabolic syndrome, fatty liver, type 2 diabetes, sleep apnea syndrome, gastroesophageal reflux disease, ischemic heart disease, urinary incontinence, mobility issues), or for those with a BMI between 30–35 whose blood sugar remains uncontrolled despite medication and insulin treatments, we recommend metabolic surgery.
Patients with Type 1 Diabetes Do Not Benefit from the Surgery
Patients with type 1 diabetes will not benefit from this treatment because they must rely on external insulin; their pancreatic insulin production is either extremely low or entirely absent.
Generally, surgeries for obesity—including these operations—are performed on individuals between the ages of 20 and 65. Patients aged 65 and over may also benefit from this treatment, provided that a thorough evaluation is conducted and there are no general contraindications for surgery.
The goal of metabolic surgery is to prevent or control the health problems and complications caused by type 2 diabetes and obesity, thereby improving the patient's quality of life.
Patients with type 2 diabetes face numerous health issues, including kidney failure, vision loss, nerve inflammations, and, most notably, ischemic heart disease. For instance, diabetes is the most common cause of adult blindness. By effectively controlling blood sugar in diabetic patients, we can protect them from kidney failure, heart-related problems, and vision loss.
In appropriately selected patients, metabolic surgery has a very high success rate, providing long-lasting and effective control of blood sugar and weight.
The surgeries are performed entirely through minimally invasive (closed) techniques. They are not the large, open surgeries of the past; instead, they are performed endoscopically through 3–5 small incisions.
We can have our patient up and walking just 4 hours after surgery. The next day, we begin feeding them liquid foods. Provided the patient avoids strenuous activities, they can resume their normal routine within 1 week to 10 days. Because the surgery does not involve large incisions, patients can return to social life much sooner.
Samsun Has Become an Important Center
Samsun has emerged as a significant hub for health tourism in Turkey. In our center, we have treated many patients from Spain, Germany, Kosovo, the USA, Albania, Romania, and Macedonia. These patients come with high blood sugar levels, and after surgery, they return for follow-up free from their medications and excess weight. This outcome brings immense satisfaction to me and my colleagues. Contributing to people’s healthy lives is a great joy for us. Moreover, it is gratifying that while treating these patients, we also promote our beautiful city of Samsun and the Black Sea region to those who previously knew little about them.
Associate Professor Dr. Kerim Güzel
General Surgery Specialist
