Genetic factors, poor diet, sedentary lifestyle, and hormonal disorders are among the causes of diabetes. In the long term, diabetes can lead to high blood pressure, obesity, high cholesterol, vascular diseases, eye diseases, tissue and organ damage, and failure in organs such as the heart and kidneys. Once diagnosed, depending on the course of diabetes, lifestyle changes based on diet and exercise are made first, followed by drug treatment after a while. Now, let's move on to information about Ileal Interposition Surgery, including what it is, who should have it, and the pre- and post-operative process.
What is ileal interposition?
Ileal interposition surgery In this process, the stomach is transformed into a banana-like, tube-like shape, reducing its volume. The first section of the small intestine is swapped with the last section, which is then connected to the duodenum. This reshapes the connection between the stomach and the insulin hormone that would otherwise come from the lower part of the intestine.
Ileal interposition is considered the most effective method for patients with type 2 diabetes. Diabetes-related conditions such as hypertension and high cholesterol will also be treated with this surgery. For type 2 diabetes patients to be eligible for this surgery, their pancreas must be able to produce insulin or be in a condition to do so.
The surgery, performed laparoscopically under general anesthesia, involves making six small incisions in the abdomen. Due to its complexity compared to other metabolic surgeries, the operation takes between 4 and 6 hours.
Who should have ileal interposition surgery?
Ileal Interposition surgery Individuals over the age of 18 with type 2 diabetes can undergo this procedure. However, not every type 2 diabetic patient is eligible for this surgery. The pancreas must have a sufficient insulin reserve to produce insulin. Prior to surgery, the patient is also questioned about whether they have previously tried diet, exercise, and medication without success.
The Process Before and After Ileal Interposition
Prior to ileal interposition, smoking, alcohol, and drug use must be stopped. Detailed examinations of the patient's health status are necessary. A comprehensive blood test, assessment of internal organ condition, medications used, etc., should be conducted to take precautions against potential complications during and after surgery. Furthermore, the patient must be psychologically prepared for the surgery. If they have any anxieties, doubts, or tension, it is crucial to provide support in this regard beforehand.
After surgery, the patient stays in intensive care for one day. From the second day onwards, when transferred to the ward, the patient begins to stand up and walk. They are discharged within 4-5 days. During this time, rest is necessary, and strenuous activities should be avoided. The patient can return to their home life from the second week onwards and to office life after 3 or 4 weeks. Jobs requiring physical activity can be resumed from the third month onwards.
Ileal Interposition surgery Individuals with this condition should drink 2 liters of water per day. They should consume liquids for the first two weeks, followed by pureed foods. The transition to solid foods should be gradual, and food should be chewed thoroughly. They should avoid refined products and stay away from acidic and carbonated drinks. They should not eat fatty or carbohydrate-rich foods. They should focus on a protein-rich diet and take supplements under medical supervision if there are any vitamin or mineral deficiencies.
What is the difference between ileal interposition surgery and transit bipartition surgery?
Transit bipartition And ileal interposition are two methods in the field of metabolic surgery. While both methods are quite successful, transit bipartition can be considered a more advanced technique. The reason ileal interposition surgeries are still performed despite the existence of a more advanced technique is that not every method is suitable for every patient. In other words, despite all their differences, advantages, and disadvantages, the method is chosen according to the patient. The differences between the two methods can be summarized as follows:
- After ileal interposition surgery, there is only one bowel pathway. After transit bipartition surgery, the bowel pathway becomes two.
- In ileal interposition surgery, the digestion time remains unchanged. The digestion time before and after surgery is equal. However, in transit bipartition surgery, the digestion time is significantly shortened because a second bowel pathway is created.
- The feeling of fullness is generated by cells located in the middle of the small intestine. With transit bipartition surgery, the middle section is moved higher, resulting in an earlier feeling of fullness. In ileal interposition surgery, however, this change does not occur.
- Transit bipartition surgery is more successful in equalizing internal pressure. This is mainly because the stomach has two outlets. In ileal interposition surgery, however, certain precautions must be taken to avoid increasing pressure.
- Fewer vitamin and mineral supplements are given after ileal interposition surgery.
These are the general differences between the two metabolic surgical procedures. Both surgeries yield highly successful results when performed on the appropriate patient.