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| Name | Ileal Interposition - Type 2 Diabetes Surgery for Non-Obese Patient with BMI: 25 kg/m2 |
| Video Uploader | Video From Tugrul Demirel |
| Upload Date | This Video Uploaded At 09-11-2018 00:46:30 |
| Video Discription | Type 2 Diabetes can be treated in selected patients with surgery. Its a well known phenomenon that type 2 diabetes can resolve after bariatric surgery in severely obese patients BMI over 35 kg/m2. However, standard bariatric procedures can not solve the same problem in mild obese and non-obese patients with BMI between 25-35 kg/m2. RYGB (Roux-N-Y Gastric Bypass) has a potent control over diabetes in morbidly obese patients; however the efficacy of the RYGB surgery reduces significantly in mild obesity (BMI less than 35 kg/m2). Duodenoileal Interposition with Diverted Sleeve Gastrectomy (DII-DSG) is a unique surgical intervention that can treat non obese diabetics safely and efficiently between 25 - 35 kg/m2. Let's shortly go over DII-DSG step by step: 1. Non Malabsorptive The focus of the operation is to stimulate the very distal ileal part of the small intestines. This goal is achieved by total transfer of a long segment of ileum rather than bypassing a long part of proximal intestines. It can simply be defined as an autologus transplantation of someones own intestines to him or herself to proximal anatomical position. This allows food to be transferred directly to the very distal part of intestines which is hormonally active. And after this segment again diverted to the very beginning of the intestines. This allows food to almost completely to be absorbed as in gastric bypass. 2. Strong and Efficient Foregut Supression Foregut means and defines the beginning of the intestines. This part of proximal intestines are responsible from the balance of insulinar action in normal beings. But in Diabetes, the physiologic anti-insulin response results as a potent insulin suppression. The elimination of food to proximal intestines, prevents this anti-insulin effect and enhances glucose homeostasis. DII-DSG ensures an anatomical diversion of whole gastric content away from duodenum and has a potent foregut suppression to achieve a normal glycemic control. 3. Definitely Potent Hindgut Stimulation The distal part of small intestines are responsible from production of satiety hormones; namely GLP-1 and Polypeptide YY. These are responsible from the satiety after meal and moreover especially GLP-1 has strong insulin supporting effects. The DII-DSG Surgery, brings the very distal end of the small intestines to exactly the very proximal position where ileal stimulation peaks anatomically. This provokes a "physiologic and normal GLP-1 response". Its shown in different surgical techniques that surgically induced GLP-1 production can be preserved more than 20 years. This makes DII-DSG a potent and long-lasting diabetes surgery technique. For further information visit our website: https://www.tugruldemirel.com/en/# Write us on whatsup: +905327699919 |
| Category | Education |
| Tags | diabetes | diabetessurgery | bariatricsurgery | type 2 diabetes |
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