Ileal Interposition Surgery

Some diseases may occur in people with the effect of reasons such as eating habits, genetic predisposition and getting used to a sedentary life. Diabetes and obesity are common among them. Since diabetes is a metabolic disease, people may experience cardiovascular problems, blood pressure problems, weight gain and cholesterol. With the serious progression of diabetes, surgical operations should be applied in the treatment plan. Ileal interposition surgery changes the structure of the intestines in the digestive system and eliminates diabetes. Elimination of obesity problems due to diabetes is one of the points targeted by this surgery.

Detailed information on what ileal interposition surgery is and in what situations it is applied will be discussed under the following headings:

• What is ileal interposition?
• In which situations and for whom is ileal interposition surgery suitable?
• How is ileal interposition applied?
• What are the advantages of ileal interposition?
• What are the risks of ileal interposition surgery?

What is Ileal Interposition Surgery?

One of the surgical operations applied in advanced stages in the treatment of type II diabetes is ileal interposition surgery. With this surgery, it is aimed to eliminate the cholesterol and high blood pressure problems that develop in the patients. This operation, also known as diabetes surgery, can also be applied to obesity patients who have excess weight problems.

In which situations and for whom is ileal interposition surgery suitable?

Before the ileal interposition surgery is performed, the general health status of the patient is evaluated and the following items are checked:

• In order to understand the condition of the kidneys, urine and blood tests are performed and controls are provided.
• In particular, the patient is expected to be over the age of 18.
• It is more preferable not to have drugs that are used continuously.
• In order for this surgery to take place, the patient must have type 2 diabetes.
• It is important in patient evaluation that non-surgical methods have been tried before the surgery and that this surgery is applied at the last stage.
• It is expected that the person's body mass index should not be 35+. If this is the case, referral to bariatric surgery will be made.

How Is Ileal Interposition Applied?

Ileal interposition surgery is an operation performed on patients under general anesthesia. The surgery is mostly performed using a closed technique with microsurgery. If the patient's condition is not suitable for this method, open surgery will be preferred. During the operation, the volume of the patient's stomach is reduced and the stomach is turned into a tube. The aim here is to reduce the patient's appetite after surgery.

In the next stage, some operations are performed on the small intestine. The duodenum is disconnected from the stomach. The first part of the small intestine and the last part are replaced. After repositioning the lower end of the stomach, the new connection of the stomach and intestine is adjusted for transfer to the upper region. The target in this process is the secretion of insulin hormone as soon as the food comes to the stomach and intestine. With the surgery, insulin resistance is broken and the patient can manage the weight loss process well.

What are the Advantages of Ileal Interposition?

This surgery, which is applied after diabetic patients have tried many methods and failed, results in a considerably high success rate. A complete resolution of diabetes in patients can be achieved by surgery. At the same time, it can be effective against obesity and solve sugar problems and obesity at the same time. This provides a great advantage for the patient.

What are the risks of Ileal Interposition?

Ileal interposition surgery, which takes about 4-5 hours, may carry some risks, as it is an operation performed under general anesthesia. In addition to these risks that may occur due to anesthesia, the patient's attention to alcohol and cigarette use before entering the surgery is required to reduce the risks. It is also important that drugs such as blood thinners are not taken. When attention is paid before the surgery and the examinations are provided as planned, the risks that may occur in the surgery will be reduced as well. However, if these are not taken care of, especially obesity patients, which may also occur after surgery; may observe swelling, pain, or clots in their legs. Patients who smoke may experience wounds and infections in the lungs.

In order to minimize the risks that may occur after ileal interposition surgery, the following two points should be considered:

• Although it is expected that diabetes will disappear after the operation, this will not happen all at once. The patient should take care of his diet for at least 4-8 months. The diet, which progresses in the form of liquid-pure-solid, should be carried out under the control of a doctor and dietitian.
• In particular, patients with obesity may not feel anorexia at first. In this case, they should try to fight the urge to overeat for the first few weeks.