Through a successful laparoscopic SADI-S surgery performed at Near East University Hospital, the health of 66-year-old Cemaliye Buba, who had been suffering from uncontrolled type 2 Diabetes and Resistant Hypertension for 39 years was restored. After the successful operation, the patient has abandoned the use a handful of drugs and insulin that she had to use every day.

66-year-old Cemaliye Buba, mother of three children in Hamitköy, had been living with Type 2 diabetes and resistant hypertension for 39 years. Despite using insulin pump for anti-diabetic therapy and many medications for resistant hypertension, the patient has not achieved to take the diabetes mellitus under control. The patient's health has been restored with a successful SADI-S operation, which is an effective therapeutic option for obese patients with diabetes mellitus, performed at Near East University Hospital by Obesity, Diabetes and Reflux Surgery Specialist Dr. Serkan Ayhan. Thanks to the successful operation, the patient, who gained her health back, will be able to maintain her life without using medication and anti-diabetic insulin therapy.

Op. Dr. Serkan Ayhan: “Diabetes leads to many health problems including organ damage"
Underlining that obesity was one of the primary causes of Type 2 Diabetes Mellitus; Op. Dr. Serkan Ayhan stated that SADI-S was a feasible operation with a promising weight loss and diabetes resolution in candidates suitable for surgery. "The patient admitted to Obesity, Diabetes and Reflux Surgery Clinic of Near East University Hospital with a complaint of Type 2 Diabetes and Resistant Hypertension that she had a history of 39 years. As the prescribed diabetes treatment regimen didn't help to keep the disease under control and the condition worsened by time, the patient was evaluated for SADI-S, which is a novel surgery technique for weight loss and diabetic resolution. Following the patient's physical examinations and blood tests, it was concluded that Cemaliye Buba with 1.64 cm height, 103 kg weight and 39.23 body mass index and adequate pancreatic insulin reserve was a good candidate for surgical procedure. As creatinine levels started to increase, our patient also suffered from renal failure due to diabetes and had to undergo surgery as soon as possible. Therefore, we immediately performed the surgery" said he.

Three treatments via a single surgical procedure...
Highlighting that Cemaliye Buba underwent a surgery primarily for uncontrolled Type 2 Diabetes, Op. Dr. Serkan Ayhan stated that the patient's stomach was reduced via tube stomach method during the operation and the secretion of appetite regulating hormone was by-passed. "The last part of the small intestine was directly attached to duodenum to allow pancreatic digestive juices and insulin hormone regulating blood hormone to flow into this part of intestine. As a result of these changes, food bypasses most of the small intestine, limiting the absorption of calories and nutrients and allowing insulin hormone to be more active. This, together with more active insulin and the smaller size of the stomach, leads to weight loss and resolution of diabetes and elimination of hypertension problem" noted he.

Expressing that blood sugar level of the patient was about 300 during the preoperative and intraoperative process, Op. Dr. Serkan Ayhan stated that the blood sugar level reduced to 200 a day after operation. "Without administration of insulin, the fasting blood glucose of the patient was counted as 89 on the 4th day, on which the patient was discharged”.

Cemaliye Buba's daughter Fatma Buba Mutlu's explanation regarding her mother's health;
Expressing that she was worried and felt low when she brought her mother to Near East University, Fatma Buba Mutlu stated that her mother's health was restored following the appropriate treatment and surgical process. "We have understood that we have come to the right place for the most effective treatment. Now, my mother's health has been restored and we are able to go back our home healthily".

Op. Dr. Serkan Ayhan: "Considering the patient's conditions, we decide the type of surgery and tailor a personalized surgical procedure for each patient"
Expressing that morbit obesity, which is closely associated with diabetes mellitus, resistant hypertension, may shorten the life span and lead to mortality, Op. Dr. Serkan Ayhan stated that they evaluated the patient's suitability for surgical treatment and performed SADI-S, which is an effective and feasible operation with a promising weight loss and diabetes resolution, to restore the health of the patient suffering from type 2 diabetes and resistant hypertension due to morbit obesity. "The surgical technique to be applied is determined by considering the patient's clinical findings, co-morbidities and patient-based treatment goals" noted he.

Op. Dr. Serkan Ayhan: "Our Patients certainly feel no pain during intraoperative and postoperative process"
Stating that patients could stand up and walk around the same day after the operation, Op. Dr. Ayhan underlined that the intraoperative and postoperative process was painless. "We do not prescribe painkillers to the patients that undergone surgical operations. As we perform bladeless and painless operations, our patients certainly feel no pain. On the day following the operation, very low dose insulin is administrated to the patients with diabetes mellitus. We expect that the blood sugar level of our diabetic patients will be in regular order within a week or the latest within two months" said he.

Two alternative surgery techniques are performed for patients with Type 2 Diabetes...
The weight loss surgery via two alternative surgical techniques for patients with Type 2 Diabetes, which are the firsts of their kinds in Cyprus, is performed by Obesity Diabetes and Reflux Surgery Specialist Op. Dr. Serkan Ayhan at Near East University Hospital.

Illeal Interposition with Sleeve Gastrostomy is a novel surgical technique for treating Type 2 Diabetes associated with morbid obesity. In recent weeks, this novel laparoscopic surgical technique was performed to restore the health of Hülya Dereli, a patient suffering from diabetes mellitus. During the laparoscopic operation, the stomach was tubed and the first and last parts of intestine were displaced to reduce the size of stomach and secretion of the appetite regulation hormone. The reduction in the stomach size and appetite regulation hormone prevents the patient from eating and drinking too much and urinating frequently. The displacement of the first and last parts of the small intestine leads the displacement of GRP1 hormone, which is normally in the last part of small intestine. Thus, pancreas is stimulated for insulin secretion to regulate blood sugar. Consequently, the diabetes mellitus is taken under control.

SADI-S is another novel technique for treating patients with diabetes associated with morbid obesity. This technique that performed to restore the health of Cemaliye Buba, is used to tube the stomach and reduce the secretion of the appetite regulation hormone. The last part of the small intestine is directly attached to duodenum to form the duodenum switch to allow blood sugar regulating insulin hormone to be more active. All these changes lead weight loss, the recovery from diabetes mellitus and the elimination of hypertension associated with obesity.