Transit Bipartition

“I have high blood sugars, and Type 2 diabetes is not going to kill me. But I just have to eat right, and exercise, and lose weight, and watch what I eat, and I will be fine for the rest of my life.”

– Tom Hanks

Transit Bipartition

Type 2 Diabetes and Metabolic Surgery​

Type 2 diabetes is a disease that occurs in the middle and old age, and 90% is caused by obesity. Obesity and diabetes, which is one of the most important diseases of our age, has become a threat to public health. Nutrition and inadequate physical activity with high energy foods starting from the age of child bring obesity. Particularly the abdominal circumference shows the fat around the internal organs, which is the precursor of the metabolic syndrome. Metabolic syndrome; high blood pressure, diabetes, high cholesterol, and 88 cm abdominal circumference in women and 102 cm in men. The presence of two or more of them in a person indicates the presence of metabolic syndrome in that person. Metabolic syndrome is a set of diseases that pave the way for cardiovascular diseases. To eliminate this situation urgently, life and nutrition should be changed first. Diet and sports must be done. When unsuccessful, which often results in failure, there is great benefit in performing obesity and metabolic surgery.

Transit Bipartition

Transit bipartition surgery is one of the surgical methods of metabolic surgeries. Metabolic surgery is a surgical procedure performed for individuals with parameters such as type 2 diabetes, high cholesterol, high blood pressure and increased abdominal circumference. Transit bipartition surgery is performed laparocopically. Surgery is performed with five incisions with the smallest 0.5 cm and the largest 2 cm. These incisions are entered into the abdominal cavity with special tools. The abdominal cavity is inflated with carbon dioxide gas to allow surgery and to provide sufficient space. First, the omentum on the left side of the stomach is separated from the majus (intraabdominal adipose tissue) and released. Starting from a distance of 6 cm to the stomach exit section, the stomach is cut and sewed with special materials. Approximately 70% of the stomach is removed. After the operation, the intestine is measured 100 cm backwards from the junction of the small intestine and the large intestine and marked here. From here onwards, a 150 cm intestine is counted and the small intestine is divided into two parts from a total of 250 cm. The tip of the lower small intestine is joined to the gastric outlet section. The upper intestinal end is joined to the first marked 100 cm intestinal portion. Thus, the operation is ended.

With this surgery, one third of the food goes through the normal old way and two thirds of the food goes through the newly created way. When most of the food that is not fully digested from the stomach comes directly into the last 2.5 meters of the small intestine, the hormone GLP-1 is secreted there. This hormone stimulates the secretion of insulin from the pancreas and increases the effectiveness of insulin in the tissues. Thus, type 2 diabetes is completely relieved by 90-95%. In addition, other additional diseases such as concomitant high cholesterol, high blood pressure, sleep apnea syndrome, knee and joint disorders, and some respiratory diseases are completely resolved by 70-95%. With this surgery, the stomach volume will also be severely reduced and saturated with very little food. Since there will also be no appetite hormone produced from the extracted stomach, appetite and hunger are reduced. Thus, at the end of the first year, people lose 70-80% of their excess weight.

In transit bipartition surgery, iron, calcium and vitamin deficiency are not seen as food passes through the normal way. After short-term vitamin and mineral supplementation, patients do not need such drugs after 6-12 months.

This type of surgery has many advantages over closed surgery. Firstly, postoperative pain is almost absent in closed surgeries, whereas open surgery may cause pain at the site for days. Because of the lack of adequate breathing due to pain, lung problems are often encountered in open surgery. In open surgeries, the possibility of infection and opening at the operation site is much higher than in closed surgeries. Return to normal life and work in the open surgery after surgery is 1-1.5 months, while this time in closed surgery is 1 week and 10 days. Finally, open surgery has a large scar, while closed surgeries are so small that they cannot be seen.