Bariatric surgery is the general name for operations performed to achieve lasting weight loss in advanced obesity and to reverse associated conditions such as type 2 diabetes. The most common procedure is sleeve gastrectomy, followed by gastric bypass. The general criteria are a body mass index of 40 or above, or between 35 and 40 with an associated condition.
- Sleeve gastrectomy
- Gastric bypass (Roux-en-Y)
- Mini gastric bypass
- Transit bipartition
- Revisional bariatric surgery
- Endoscopic gastric balloon
- Gastric botox
- Type 2 diabetes and metabolic surgery
Obesity is not simply a weight problem; it is directly linked to type 2 diabetes, hypertension, sleep apnoea, fatty liver disease, joint disorders and certain cancers. Where diet, exercise and medical treatment fail to produce a lasting result in advanced obesity, surgery is today accepted as the most effective treatment option.
Who Is Eligible?
The internationally accepted criteria are:
- A body mass index (BMI) of 40 or above
- A BMI between 35 and 40 together with at least one obesity-related condition such as type 2 diabetes, hypertension, sleep apnoea or fatty liver disease
- Usually an age between 18 and 65
- Failure to achieve lasting weight loss despite diet, exercise and medical treatment
These numbers alone do not decide the matter. Age, eating habits, previous weight-loss attempts, psychological readiness and overall health are assessed together.
Surgical Methods
Sleeve gastrectomy
Roughly 75-80 per cent of the stomach along the greater curvature is removed laparoscopically, leaving a narrow gastric tube. It works both by restricting volume and by reducing secretion of the hunger hormone ghrelin. It is the most commonly performed bariatric operation worldwide and in Turkey.
Gastric bypass
A small gastric pouch is created and part of the small intestine is bypassed. Because its metabolic effect is stronger, it comes to the fore in patients with type 2 diabetes and significant reflux.
Mini gastric bypass and transit bipartition
Methods considered in selected patients, particularly those with very high BMI values and a heavy burden of metabolic disease.
Revisional (re-do) bariatric surgery
Secondary operations for patients who have already had bariatric surgery but have not lost enough weight or have developed severe reflux. These are technically more demanding than a first operation and require separate experience.
Endoscopic methods
Gastric balloon and gastric botox are incision-free procedures offering a temporary solution for patients who have not reached the surgical threshold or who are not suitable for surgery.
Preparation Before Surgery
Bariatric surgery is a team effort. The following are usually completed beforehand:
- General surgery consultation and the choice of method
- Endocrinology assessment
- Nutrition and dietetic counselling, with a pre-operative diet to reduce fatty liver
- Psychiatric assessment
- Endoscopy, blood tests, ECG, chest X-ray and cardiology review where needed
After Surgery
The hospital stay is most often 2-3 days. Nutrition advances in stages: liquids, purees, soft solids and then normal solid foods. Weight loss is fastest in the first six months and plateaus at 12-18 months; on average 60-70 per cent of excess weight is lost.
Vitamin B12, iron, vitamin D, calcium and folic acid supplements must be taken regularly. Follow-up with blood tests is recommended at 1, 3, 6 and 12 months in the first year, and annually thereafter.
A lasting result comes from a change in lifestyle; surgery alone is not enough.
A Bariatric Practice Kept Continuously Up to Date
Bariatric and metabolic surgery is one of the focal points of Op. Dr. Ersan Semerci's career. To date he has performed more than 3,000 sleeve gastrectomy and bariatric surgery cases. Revisional bariatric surgery is listed as a separate specialty area on his Medical Park doctor profile.
- Laparoscopic Bariatric Surgery Course, Acıbadem University Center of Advanced Simulation and Education, Istanbul (2015)
- Gastric Bypass and Beyond Core Training Course, 2nd Bariatric and Metabolic Surgery Congress (2017)
- Surgeon of Excellence Bronze Certification (2018)
- Medtronic Medical Education, Bariatric Re-Do Surgery Training, Bruges, Belgium (2023)
Consultations and operations are carried out at Medicalpark Mersin Hospital. Op. Dr. Ersan Semerci has practised in Mersin since 2010. Patients travelling from Mersin and neighbouring provinces can book via WhatsApp.
Book on WhatsAppWhich method is right for me?
The decision is made by weighing body mass index, associated conditions such as type 2 diabetes, the presence of reflux, eating habits and expectations together. Sleeve gastrectomy is generally preferred in patients without reflux, and gastric bypass in those with diabetes or significant reflux.
Is the operation covered by insurance?
SGK, the Turkish social security institution, covers bariatric surgery for patients meeting defined criteria. Coverage and required documentation vary with current regulations, so confirming before your appointment is advised.
I had bariatric surgery before but did not lose enough weight. What can be done?
This is known as revisional (re-do) bariatric surgery. A second operation may be planned after assessing the type of previous surgery, the current anatomy and your symptoms. It is technically more demanding than a first operation.
Consultation and Appointments in Mersin
For symptoms within Bariatric and Metabolic Surgery you can book an appointment at Medicalpark Mersin Hospital. Mezitli / Mersin, Turkey, weekdays 09:00-17:00.
WhatsApp: +90 542 236 05 33Disclaimer. This page is provided for general information only. It does not constitute medical advice, diagnosis or a treatment recommendation, and it is not a substitute for examination, diagnosis and treatment by a physician. The content is not tailored to any individual and is not intended as advertising. Which method is suitable for you can only be determined after examination and the necessary investigations. Consult your own doctor about any decision concerning your health.