Who is Serkan AYHAN ?

He has born on 07.02.1977 in Adana / Turkey.
In 2003, he has worked for a one year as a Practitioner in Aksaray at Ceritler Health Center.
Between 2004-2009 he has completed his education of surgery assistance in BAKIRKOY SADI KONUK EDUCATION & RESEARCH HOSPITAL located in Istanbul.
in May 2011, he has started to work as General Surgeon in Manisa at SALIHLI PRIVATE CAN HOSPITAL.
From August 2015 to July 2016, he has worked in Izmir at TORBALI PRIVATE MEDIFEMA HOSPITAL.
From July 2016 he is working in Tekirdag at CERKEZKOY PRIVATE OPTIMED HOSPITAL and he is at the head of Bariatric & Metabolic & Anti-Reflux Surgery Clinic.
Serkan AYHAN , who prepared a thesis on Obesity and Reflux Patients, performed more than 1000 obesity and anti-reflux operations and prepared a measurement report on the evaluation of patients pre and post-operative conditions.
Having an interventional and therapeutic endoscopy training certificate, he has been trained in laparoscopy, endoscopy and new open surgical techniques.
He has participated in various congresses and increased his professional experience.
In 2004, he has participated to National Surgical Society Medical Congress in Antalya .
in 2013 he has also participated to IFSO World Obesity and Metabolic Diseases Congress and worked with his colleagues at the point of solution.


1. Obesity & Metabolic Surgery

Obesity, diet programs, exercise or drug therapy are not a health problem that can be controlled individually.
This treatment is concerned with the possibility of taking back the weight. Obesity surgery is the most effective method in the treatment of obesity. . In short, surgery is applied to terminate the obesity problem.
Obesity surgery is mainly based on two principles. The main goal of the Obesity surgery is to reduce the stomach volume and / or prevent malabsorption.
The obesity surgery can be applied in case of if the patient is between 18-65 years old and has a obesity problem more than 5 years with a Body Mass Index (BMI) starting from 35 .
Obesity surgery is a kind of surgical intervention applied to the patients having an excessive weight to loss them a weight. We also call it Bariatric Surgery which comes from the word baros, which means weight in ancient Greeks.
Today, one of which is the result of increasingly widespread method of bariatric surgery is better than other methods applied. Weight loss surgery is provided by significantly reducing the mortality rate. The biggest benefit is the reduction of diseases associated to obesity.

There are also cases that are not appropriate for obesity surgery. These;

• Severe eating disorder
• Obesity continues with excessive alcohol intake
• Serious systemic diseases
• Diseases affecting the upper digestive tract
• Need for regular use of anti-inflammatory drugs

Surgery is not suitable for some obese patients. These:

• If Thyroid gland laziness, cortisone use or obesity due to endocrine organ diseases disease has occurred
• If there is an addiction to Drug, alcohol, and stimulant substances
• If there is a serious psychiatric problem
• If pregnancy is planned within 1 year, obesity surgery is not applied in these conditions.

Methods of obesity surgery can be examined under 3 headings:

1-Surgical attempts to restrict food intake.
2-Surgical interventions that reduce absorption.
3- Surgical interventions that reduce absorption and restrict food intake.

In the step of deciding to apply these surgical interventaions, the patient’s condition, needs and needs will be taken into consideration.
Post-operative pain is minimal. It passes by itself within 1-2 days and can be easily controlled with simple painkillers. Such surgery need to stay in the hospital for 2 or 3 days. 4 hours after the operation, the patient can stand up. No probes are placed in the nose or urinary tract.

Benefits of obesity surgery

• In obesity patients having a hypertension problems, there is a significant positive improvement in blood pressure measurements after the surgery.
• In obesity patients who has a diabetes Type 2, there is a serious positive improvements in blood sugar levels.
• Reduced risk of Heart Disease.
• Improves Sleep Apnea
• Breathing becomes easy.

Obesity, which is one of the most important health problems of our age, is not enough to intervene with diet and exercise practices alone, should be supported by obesity surgery.
After the application of the obesity surgery, more attention should be paid to nutrition and physical activities.

Method Used in Obesity & Metabolic Surgery


1.1 Laparoscopic Sleeve Gastrectomy

In a sleeve gastrectomy, also known as a gastric sleeve procedure, the outer margin of the stomach is removed to restrict food intake, leaving a sleeve of stomach, roughly the size and shape of a banana, and the pylorus, the muscle that controls emptying of food from the stomach into the intestine. A sleeve gastrectomy is a purely restrictive procedure.
The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Sleeve gastrectomy is a simpler operation than the gastric bypass procedure because it does not involve rerouting of or reconnection of the intestines.

• Sleeve gastrectomy operation is done by laparoscopy (Keyhole surgery)
• Appr. 80% of the stomach is taken and the person feels less hungry
• Due to the keyhole surgery application (laparoscopy), the healing process is very rapid and the pain is at minimal level
• With this operation, the treatment is provided with 85% success ratio for type II diabetes, hypertension, dyslipidemia and sleep apnea syndrome.
• Sleeve gastrectomy operation provides weight loss and treatment without sports and diet.

1.2 Laparoscopic SADI-S Surgery
(Single Anastomosis Duodeno-Ileal by pass with Sleeve Gastrectomy)-(Loop Duodenal Switch)

It is the most effective and permanent weight loss surgery technique among all obesity surgery operations. Especially in the treatment of morbid obesity and type II diabetes mellitus (DM) , SADI-S is obviously superior and provide a much stronger and lasting weight loss comparing with the Mini Gastric Bypass and the Roux en Y Gastric Bypass operations.
Protein, vitamin and mineral loss is less common as sadi-s surgery due to the less restriction of absorption.
Sadi-S surgery does not intervene in the pylorus muscle and the volume of the stomach is not too small, the patient’s eating does not cause difficulties. if attention is paid to the calorie taken, weight loss is faster.SADI-S is done by laparoscopy (Keyhole surgery)
• Due to the keyhole surgery application (laparoscopy), the healing process is very rapid and the pain is at minimal level
• This surgery permanently terminates type 2 diabetes mellitus (DM) and Diabetes is controlled withing a few weeks to few months after this surgery.
• SADI-S operation provides weight loss and treatment without diet and sports

1.3 Laparoscopic Gastric By-Pass (ROUX-EN-Y)

Gastric by-pass surgery makes the stomah smaller and causes food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size. This reduces the amount of food you can eat at one time. By passing part of the intestine reduces how much food and nutrientss are absorbed. This leads to weight loss.
One type of gastric by-pass surgery is a Roux-en-Y gastric by-pass
In normal digestion , food passes through the stomach and enters the small intestine where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.
In a Roux-en-Y gastric by-pass, only a small part of the stomach is used to create a new stomach pouch, roughly the size of an egg. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).
This procedure is done by making several small incisions and using small instruments and a camera to guide the surgery (laparoscopic approach).
In a gastric by-pass, the part of the intestine where many minerals and vitamins are most easily absorbed is by-passed. Because of this, you may have a deficiency in iron, calcium, magnesium, or vitamins. This can lead to long-term problems, such as osteoporosis. To prevent vitamin and mineral deficiencies, you may need to work with a dietitian to plan meals. And you may need to take extra vitamin B12
This surgery is suitable for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.
Surgery is generally considered when your body mass index (BMI) is 40 or higher.
Surgery may also be an option when your BMI is 35 or higher and you have a life-threatening or disabling problem that is related to your weight, such as type 2 diabetes that is difficult to control with diet, exercise, and medicine.

1.4 Laparoscopic Ileal Interposition with Sleeve Gastrectomy

The term Ileal Interposition, in brief, is a kind of exchange of the initial and final parts of the small intestine and transforming the stomach in banana shape.
This surgery is the method used in the treatment of Type 2 Diabetes ONLY to the patients who has a Pancreatic Insulin reserve
This operation is a different surgery than obesity surgery.
The mechanism of action of this surgery is to disable the hormones that cause insulin resistance and to increase hormone levels that increase insulin sensitivity.
Vitamin and mineral deficiencies are not seen and followed as in the by-pass operations of the obesity surgery because this operation technique is not performed by intestine by-pass and no need to use vitamins and minerals containing pills during whole life.
In the ileal interposition surgery, , the liquid consumption starts from the third of the operation.
Within 6 months to 1 year completely free nutrition can be passed.
With this surgery, diabetes is controlled within a few weeks to a few months and drug treatment can be given at low dosage according to the patient condition.
• Due to the keyhole surgery application (laparoscopy), the healing process is very rapid and the pain is at minimal level
• This surgery permanently terminates type 2 diabetes mellitus (DM) and Diabetes is controlled withing a few weeks to few months after this surgery.
• Ileal Interposition with Sleeve Gastrectomy operation provides weight loss and treatment without diet and sports

2. Anti-Reflux (GERD) Surgery (GastroEsophageal Reflux Disease)

Anti-reflux surgery is a treatment for acid reflux, also known as GERD(gastroesophageal reflux disease). GERD is a condition in which food or stomach acid come back up from your stomach into the esophagus. The esophagus is the tube from your mouth to the stomach.
Reflux often occurs if the muscles where the esophagus meets the stomach do not close tightly enough. A hiatal hernia can make GERD symptoms worse. It occurs when the stomach bulges through this opening into your chest.
Symptoms of reflux or heartburn are burning in the stomach that you may also feel in your throat or chest, burping or gas bubbles, or trouble swallowing food or fluids.

The most common procedure of this type is called fundoplication. In this surgery, your surgeon will:
• First repair the hiatal hernia, if one is present. This involves tightening the opening in your diaphragm with stitches to keep your stomach from bulging upward through the opening in the muscle wall. Some surgeons place a piece of mesh in the repaired area to make it more secure.
• Wrap the upper part of your stomach around the end of your esophagus with stitches. The stitches create pressure at the end of your esophagus, which helps prevent stomach acid and food from flowing up from the stomach into the esophagus.

2.1 Laparoscopic Floppy Nissen Fundoplication


• Due to the keyhole surgery application (laparoscopy), the healing process is very rapid and the pain is at minimal level.
• Operation has 99% success ratio
• Clinical complaints disappear completely the day after surgery
• Due to the keyhole surgery application (laparoscopy), the healing process is very rapid and the pain is at minimal level.

3. Other Performed General Surgery Operations and Applications

• Laparoscopic Cholecystectomy
• Laparoscopic Omentoplasty
• Laparoscopic Appendectomy
• Gastric Cancer Surgery
• Colorectal Cancer Surgery
• Volvulus Surgery
• Thyroid Cancer Surgery
• Goitre Removal Surgery
• Umbilical Hernia Surgery
• inguinal Hernia Surgery
• incisional Hernia Surgery
• Mastectomy
• Liver Hydatid Cyst Surgery
• Pılonıdal Sınus Surgery
• Anal Fissure Surgery
• Anal Fistula Surgery
• Hemorrhoid Surgery
• Longo Surgery
• Endoscopy
• Colonoscopy
• Percutaneous Endoscopic Gastrostomy (PEG)