{"id":523,"date":"2024-03-01T19:32:06","date_gmt":"2024-03-01T19:32:06","guid":{"rendered":"https:\/\/istanbulbariatrics.com.tr\/?page_id=523"},"modified":"2024-03-01T19:32:06","modified_gmt":"2024-03-01T19:32:06","slug":"kime-hangi-ameliyat","status":"publish","type":"page","link":"https:\/\/mehmetaliyerdel.com\/?page_id=523","title":{"rendered":"Kime, Hangi Ameliyat?"},"content":{"rendered":"\t\t
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Kime Hangi Ameliyat?<\/span><\/h1>\t\t\t\t<\/div>\n\t\t\t\t
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\u0130lk ameliyat se\u00e7ene\u011fi olarak \u201cby-pass\u201d y\u00f6ntemleri ise \u00e7ok nadiren ve sadece v\u00fccut kitle indeksi 60\u2019\u0131n \u00fcst\u00fcndeki (s\u00fcper s\u00fcper obezite), ya da uzun s\u00fcredir ins\u00fclin alan \u00e7ok eski tip 2 diyabet varl\u0131\u011f\u0131nda kullan\u0131lmaktad\u0131r.<\/p>

Bu ama\u00e7la da y\u0131llar boyu bir alt\u0131n standart olarak kabul edilmi\u015f \u201cmide-bypass\u2019\u0131\u201d (gastric by-pass) ameliyat\u0131 tac\u0131n\u0131 \u201cbirincil\u201d olgularda \u201ct\u00fcp mide\u201d, \u201cikincil\u201d olgularda ise \u201cduodenal switch\u201d ameliyat\u0131na devretmi\u015f durumdad\u0131r ! Zaman\u0131m\u0131zda birincil cerrahi se\u00e7enek olarak mide by-pass\u2019\u0131 giderek azalan oranlarda uygulanmaktad\u0131r, ve hatta \u00e7oklar\u0131nca terk edilmi\u015ftir. Bunun en \u00f6nemli nedeni ise geri kilo alma oranlar\u0131n\u0131n \u201ct\u00fcp mide\u201d \u2018den \u00e7ok farkl\u0131 olmamas\u0131 ve buna kar\u015f\u0131n geri kilo al\u0131m\u0131 oldu\u011funda by-pass giri\u015fiminin ba\u015fka bir ameliyata d\u00f6n\u00fc\u015ft\u00fcr\u00fclmesindeki a\u015f\u0131r\u0131 teknik zorluklar ve HATTA imkans\u0131zl\u0131klard\u0131r. \u00d6te yandan kilo kayb\u0131 ve \u015feker \u00fcst\u00fcne benzer etkileri olan \u201ct\u00fcp mide\u201d giri\u015fimi; uzun y\u0131llar sonra ba\u015far\u0131s\u0131z da olsa, rahatl\u0131kla herhangi bir ba\u015fka ameliyata d\u00f6n\u00fc\u015ft\u00fcr\u00fclebilmektedir. Hatta ikinci kez bir t\u00fcp mide ameliyat\u0131 (re-sleeve) bile yap\u0131labilmekte ve halen son kur\u015fun (by-pass y\u00f6ntemleri) daha ileride kullan\u0131lmak \u00fczere ileri bir tarihe saklanabilmektedir.<\/p>

Mide by-pass\u2019\u0131n\u0131n anatomik bir giri\u015fim olmay\u0131\u015f\u0131, b\u00fcy\u00fck bir mide b\u00f6l\u00fcm\u00fcn\u00fcn \u00e7\u0131kart\u0131lmadan \u201ck\u00f6r\u201d bi\u00e7imde geride b\u0131rak\u0131lmas\u0131, bunun yol a\u00e7t\u0131\u011f\u0131 \u201cendoskopi\u201d yap\u0131lamama problemi ve ba\u015far\u0131s\u0131z olundu\u011funda bir ba\u015fka giri\u015fime \u00e7evrilmesindeki zorluklar bir zamanlar konunun \u201calt\u0131n standard\u0131\u201d olarak kabul g\u00f6rm\u00fc\u015f bu giri\u015fimin anlam ve \u00f6nemini de\u011fi\u015ftirmi\u015ftir. \u00d6rne\u011fin klini\u011fimizde mide \u2013 by pass\u2019\u0131 art\u0131k sadece \u00f6nceden ba\u015far\u0131s\u0131z olmu\u015f bir t\u00fcp mide ameliyatl\u0131s\u0131na ikinci ameliyat se\u00e7ene\u011fi olarak \u00f6nerilebilmekte ve bunu d\u0131\u015f\u0131nda hemen hemen art\u0131k hi\u00e7 kullan\u0131lmamaktad\u0131r.<\/p>

Dolay\u0131s\u0131 ile bir morbid obezite hastas\u0131 \u00f6zellikle gen\u00e7 biri ise, tek ameliyatla konunun \u00e7\u00f6z\u00fclemeyebilece\u011fini ve ileride bir ikinci giri\u015fime gerek duyulabilece\u011fini iyi bilmeli ve cerrahi ekiple de bu bilin\u00e7le konu\u015fmal\u0131d\u0131r. Bu ba\u011flamda \u201ct\u00fcp mide\u201d giri\u015fimi \u00f6zellikle ilk kez \u015fi\u015fmanl\u0131k ameliyat\u0131 olacak olgularda art\u0131k bir yeni \u201cALTIN STANDART \u201d<\/strong> olarak kabul edilebilir.<\/p>

Mide-bypass\u2019\u0131 y\u00f6ntemi ise baz\u0131 ikincil olgular\u0131n tedavisinde halen ge\u00e7erlili\u011fini koruyan , \u00f6nemli, fakat \u201cduodenal switch\u201d ameliyat\u0131 \u00e7\u0131kt\u0131\u011f\u0131ndan bug\u00fcne \u00e7ok daha nadiren ve sadece \u00f6zel ko\u015fullarda uygulad\u0131\u011f\u0131m\u0131z bir ameliyat olmu\u015ftur diyebiliriz.<\/p>

\u00d6te yandan ilk giri\u015fimin ba\u015far\u0131s\u0131z olup, ikinci kez bir \u015fi\u015fmanl\u0131k ameliyat\u0131 olunaca\u011f\u0131nda; by-pass y\u00f6ntemleri hali ile ba\u015f\u0131 \u00e7ekmektedir ve bu \u201csekonder (ikincil) \u201d olgular\u0131n tedavisinde en s\u0131k ba\u015fvurdu\u011fumuz ameliyatlard\u0131r.<\/p>

Sonu\u00e7 olarak hangi hastaya hangi ameliyat\u0131n yap\u0131laca\u011f\u0131 karar\u0131 b\u00fcy\u00fck \u00f6l\u00e7\u00fcde hastaya ait bir dizi \u00f6zellik ile ilgilidir :<\/strong><\/p>

  • \u00d6nceden herhangi bir \u015fi\u015fmanl\u0131k ameliyat\u0131 uygulan\u0131p uygulanmam\u0131\u015f olmas\u0131 bu kararda birincil derecede \u00f6nemlidir.<\/li>
  • Tip 2 \u015feker durumu ve hastan\u0131n ya\u015f\u0131 da bu karar\u0131 etkiler.<\/li>
  • Son olarak da; ekibin deneyimi de bu se\u00e7imde rol oynar.<\/li><\/ul>

    Dolay\u0131s\u0131 ile cerrahi ekibin hem konunun t\u00fcm felsefesine hakim olmas\u0131 ve hem de t\u00fcm bariatrik prosed\u00fcrleri bilmesi ve m\u00fckemmel bi\u00e7imde uygulayabilir olmas\u0131 da bir \u00f6n ko\u015fuldur.<\/p>

    \u00d6zet olarak bir morbid obezite hastas\u0131 ile kar\u015f\u0131 kar\u015f\u0131ya geldi\u011fimizde, e\u011fer ameliyat tedavisine engel \u00f6zel bir durum da yoksa; hastaya ait t\u00fcm \u00f6zellikleri bir bir ortaya koyup , hastan\u0131n kendisi ile de t\u00fcm tedavi se\u00e7eneklerinin art\u0131 ve eksilerini tart\u0131\u015farak en uygun giri\u015fim \u201c\u00f6zenle\u201d planlanmal\u0131d\u0131r.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Ameliyat<\/strong>, size tek ba\u015f\u0131n\u0131za ba\u015faramayaca\u011f\u0131n\u0131z kilo hedefinize ula\u015fmaya yard\u0131m ediyor.<\/p>

    Bu ba\u015far\u0131y\u0131, sa\u011fl\u0131kl\u0131 bir \u015fekilde s\u00fcrd\u00fcrebilmenizde profesyonel ekibimiz<\/em><\/strong>, size \u00f6m\u00fcr boyu destek<\/strong> sunuyor.<\/p>

    Amac\u0131m\u0131z; sizi her daim sa\u011fl\u0131kl\u0131, mutlu<\/strong> ve fit<\/strong> g\u00f6rmek.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Kime Hangi Ameliyat? \u0130lk ameliyat se\u00e7ene\u011fi olarak \u201cby-pass\u201d y\u00f6ntemleri ise \u00e7ok nadiren ve sadece v\u00fccut kitle indeksi 60\u2019\u0131n \u00fcst\u00fcndeki (s\u00fcper s\u00fcper obezite), ya da uzun s\u00fcredir [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":479,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-523","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/pages\/523","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=523"}],"version-history":[{"count":0,"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/pages\/523\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=\/wp\/v2\/pages\/479"}],"wp:attachment":[{"href":"https:\/\/mehmetaliyerdel.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=523"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}