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Konuşmacı, kliniğinde yaşam koçları olarak görev yapan Selma Hanım ve spor bölümünü idare eden bir bayanla birlikte çalışmaktadır.","Sunum, obezitenin nedenleri, tedavi yöntemleri ve cerrahi seçenekleri (mide kelepçesi, gastrik bypass, tüp mide, switch ameliyatları) hakkında kapsamlı bilgiler sunmaktadır. Ayrıca ameliyat sonrası takip protokolleri, komplikasyonlar ve mortalite oranları detaylı şekilde anlatılmaktadır.","Konuşmacı, obezitenin kronik bir hastalık olduğunu, bariatrik cerrahinin en etkin yöntemlerden biri olduğunu ancak sadece bir anahtar olduğunu vurgulamaktadır. Türkiye'deki obezite cerrahisi durumu, tıp eğitiminde bu konunun yer almayışı ve otorite eksikliği gibi sorunlar da ele alınmaktadır. Konuşmacı, hastaların sadece kilo vermesi değil, hayatlarına yeni bir anlam katması gerektiğini ve multidisipliner bir merkez kurma hedefini de paylaşmaktadır."]},"endTime":1352,"title":"Obezite Cerrahisi ve Bariatrik Tedavi Sunumu","beginTime":0}],"fullResult":[{"index":0,"title":"Obezite ve Diyet Sorunları","list":{"type":"unordered","items":["Obezite ve açlık sorunları ciddi boyutlara ulaşmış durumda; üç milyon kişi obeziteden, iki milyon kişi açlıktan ölmüştür.","Obezitenin nedeni çok faktörlüdür ve diyet, cerrahi gibi farklı yöntemler bu sorunu çözmeye çalışmaktadır.","Diyetlerin başarısızlığı değil, \"yoyo sendromu\" olarak adlandırılan geri kilo alma sorunu daha büyük bir sorundur; çalışmalar gösteriyor ki yüzde doksanyedi'si geri kilo alıyor."]},"beginTime":0,"endTime":89,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=0&ask_summarization=1"},{"index":1,"title":"Obezite Cerrahisi ve Kanıta Dayalı Tıp","list":{"type":"unordered","items":["Obezite cerrahisi üç farklı gruba ayrılır: mide kelepçesi, bağırsağın bypass edildiği vaka ve tüp mide.","1991 yılında Amerikan Ulusal Sağlık Ente Cerrahi kabul etmiştir ve günümüzde morbid obezler diz protezi için obeziteden ameliyatla kurtulmadan veya denemeden bu işlemi yapamazlar.","Kanıta dayalı tıp, prospektif çalışmalardan başlayarak metal izlerden en sonda da cerrahinin görüşlerini içeren bir yaklaşımdır."]},"beginTime":89,"endTime":210,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=89&ask_summarization=1"},{"index":2,"title":"Bağırsakların Endokrin Rolü","list":{"type":"unordered","items":["Cerrahide önce ameliyatlar yapıldıktan sonra nasıl çalıştığı üzerine düşünülmüştür.","Bağırsaklar artık en büyük endokrin organ olarak kabul edilmektedir ve bypasslar yaparak şeker seviyesi düzeltilmektedir.","Lastik bağıntı ameliyatı sadece kısıtlamaya yönelik bir ameliyattı ve hormonal değişiklikler olmadığı için başarısız olmuştur."]},"beginTime":210,"endTime":301,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=210&ask_summarization=1"},{"index":3,"title":"Gastrik Bypass ve Tüp Mide","list":{"type":"unordered","items":["Gastrik bypass ameliyatı başlangıçta harika sonuçlar vermiş, tip iki diyabetler düzelmiş ve insülin alan hastalar ayağa kalkmıştır.","Uzun dönemde bypass'ın da başarısızlıkları ortaya çıkmış, özellikle süper obezlerde yüzde kırk oranında kilo alımı görülmüştür.","Bypass'ın en büyük problemi köprüleri yakan bir ameliyat olmasıdır ve yüzde altmış hastada nutrisyonel sıkıntılar ve emilim bozuklukları yaşanmaktadır."]},"beginTime":301,"endTime":395,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=301&ask_summarization=1"},{"index":4,"title":"Tüp Mide ve Obezite Cerrahisindeki Devrim","list":{"type":"unordered","items":["Tüp mide ameliyatı obezite cerrahisindeki Türkiye adına en büyük devrimdir ve Avrupa için de söylenebilir.","Tüp mide ameliyatı kolay ve hoş bir ameliyat olmasına rağmen, zaman içinde ince ayrıntıları gelişmiştir.","Tüp mide ameliyatı tesadüfen bulunmuş olup, pilorun yüksek basınç yaratması, ghrelin salgılanması ve endorfinlerin artması sayesinde doygunluk hissi bypass'a göre daha fazladır."]},"beginTime":395,"endTime":490,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=395&ask_summarization=1"},{"index":5,"title":"Tüp Mide Ameliyatları ve Gelişimi","list":{"type":"unordered","items":["Tüp mide ameliyatları iyi sonuçlar vermiş ve yaygınlaşmaya başlamıştır.","Mide genişleyebilir, ancak darlık olursa daha çok büyür; özellikle pilor nedeniyle antrum genişleyebilir.","Amerika'da bypass cerrahları terk ederek tüp mide ameliyatları öne çıkmıştır."]},"beginTime":497,"endTime":544,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=497&ask_summarization=1"},{"index":6,"title":"Tüp Mide Ameliyatının Avantajları","list":{"type":"unordered","items":["Obezite ve ameliyatlar nükslerle seyreder, tüp mide ikinci bir ameliyatın yapılmasına imkan tanır.","Tüp mide ameliyatı sonrası hazır bir mide oluşur ve bypass, switch gibi ek ameliyatlar yapılabilir.","Döven switch ameliyatı Amerika'da bile %3'lerde primer uygulanma oranına sahiptir."]},"beginTime":544,"endTime":578,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=544&ask_summarization=1"},{"index":7,"title":"Döven Switch Ameliyatının Riskleri","list":{"type":"unordered","items":["Döven switch ameliyatı sonrası protein eksikliği ve emilim bozukluğu nedeniyle hipoproteinemi gelişebilir.","Türkiye'de \"döven switch yapalım, çok kilo ver sonra kaybol\" anlayışı gelişmektedir.","Çok ciddi aşırı morbit obez, diyabetik hastalarda maloportif ameliyatlar tercih edilmelidir."]},"beginTime":578,"endTime":660,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=578&ask_summarization=1"},{"index":8,"title":"Diyabet ve Ameliyat Seçimi","list":{"type":"unordered","items":["\"Diyabetim var, gastrik bypass yapalım çünkü tüp mideyle iyileşmez\" düşüncesi yanlıştır.","Gastrik bypass tek belirleyici değildir, hastanın ağırlığı ve pankreasın rezervleri önemlidir.","Erken başlamış, insüline geçmemiş ve pankreas rezervleri iyi olan hastalarda tüp mide ile de yardımcı olunabilir."]},"beginTime":660,"endTime":713,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=660&ask_summarization=1"},{"index":9,"title":"Ameliyat Öncesi Hazırlık","list":{"type":"unordered","items":["Endokroloji, kardiyolog ve pulmoner sistemi iyi değerlendirilmelidir.","Gastroskopi, kolonoskopi, diyetisyen ve psikolog görüşmeleri yapılmalıdır.","Laboratuvar bağımsız olmalı ve hemşire ekipte olmalı, kan verme zamanı gelenleri aramalıdır."]},"beginTime":713,"endTime":766,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=713&ask_summarization=1"},{"index":10,"title":"Ameliyat Öncesi Kontroller","list":{"type":"unordered","items":["Bayanların meme kanseri açısından taranması ve hamile olmadıklarını tespit etmek gerekir.","40 yaşın üzerindekilere kolonoskopi rutin önerilmektedir.","50 yaşın üzerinde kolonoskopi yapmak hayat kurtarıcı olabilir, tubeleviz (polipler) yakalama imkanı sağlar."]},"beginTime":766,"endTime":810,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=766&ask_summarization=1"},{"index":11,"title":"Ameliyat Sonrası Takip","list":{"type":"unordered","items":["Derin ven trombozu ve pulmoner emboliye karşı low moleküler veyteparin, pnömatik kompresyon ve erken mobilizasyon uygulanır.","Ateş protokolü vardır ve CRP yüksekliğinde derhal tomografi çekme gibi protokoller uygulanır.","Hastalar üçüncü gün taburcu edilir ve ameliyata göre değişik vitaminler ve proteinler verilir."]},"beginTime":810,"endTime":857,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=810&ask_summarization=1"},{"index":12,"title":"Multidisipliner Merkez ve Takip Stratejileri","list":{"type":"unordered","items":["Multidisipliner merkez kurma hedefi vardır ve üç yıldır 12 kişilik bir ekiple klinik yürütülmektedir.","En çok rastlanan hastalıklar karaciğer yağlanması ve tip 2 diyabettir.","Ameliyat sonrası dönem dört döneme ayrılır: ilk üç gün hastanede, ilk bir ay alışma dönemi, bir ay ile bir buçuk yıl sağlıklı kilo kaybı dönemi ve kilo vermenin durduğu bir buçuk yıllık dönem."]},"beginTime":857,"endTime":942,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=857&ask_summarization=1"},{"index":13,"title":"Takip Sürecindeki Sorunlar ve Komplikasyonlar","list":{"type":"unordered","items":["Takip sırasında darlık olan hastalar çok zayıfladıkları için memnun olabilir, ancak bu ileride sorunlara yol açabilir.","Sosyal medya büyük avantaj sağlar, hastaları kaydedip ajan şeklinde takip edilebilir.","Komplikasyonlar dünya ortalamasına göre daha azdır, %2,20 kaçak oranı vardır ve mortalite yoktur."]},"beginTime":942,"endTime":1034,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=942&ask_summarization=1"},{"index":14,"title":"Bariatrik Cerrahi Tedavisinin Amacı","list":{"type":"unordered","items":["Konuşmacı, hastalara yeni bir hayata anlam katabilme konusunda hassas olduğunu belirtiyor.","Ameliyatın sadece bir anahtar olduğu hissiyatını vermek ve hastalara takip önemini anlatmak önemli.","Konuşmacı, toplantılarında hastalara nüks riski ve takip edilmezse kemik kırılma riski gibi korkutucu mesajlar vererek takibin önemini vurguluyor."]},"beginTime":1037,"endTime":1106,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=1037&ask_summarization=1"},{"index":15,"title":"Kliniğin Çalışma Yöntemi","list":{"type":"unordered","items":["Kliniğin iki yaşam koçu bulunuyor: biri spor bölümünü, diğeri ise tüm kliniğin işleyişinden ve hastaların takibinden sorumlu.","Uzun dönemde başarı oranı yüzde seksen olarak belirtiliyor.","Tedavide şeker hastalığı tam remisyona ulaşıyor, karaciğer en çok düzelenler arasında yer alıyor."]},"beginTime":1106,"endTime":1172,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=1106&ask_summarization=1"},{"index":16,"title":"Morbid Obezite ve Bariatrik Cerrahi","list":{"type":"unordered","items":["Morbid obezite kronik bir hastalıktır ve kesin bir tedavisi yoktur.","Varyattik cerrahi en etkin yöntemlerden biridir, ancak yüzde beş ile on arasında magnetrisyon (kilo alma) riski vardır.","Bariatrik cerrahi sadece kilo verdirmekle kalmayıp endokrin değişiklikler yaparak hipertansiyon ve şeker gibi yandaş hastalıkları da düzeltir."]},"beginTime":1172,"endTime":1224,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=1172&ask_summarization=1"},{"index":17,"title":"Bariatrik Cerrahinin Toplumsal Algısı","list":{"type":"unordered","items":["Toplum ve meslektaşlar bariatrik cerrahiye inanmıyor, tıp eğitiminde bariatrik cerrahi dersi olmadığı için büyük zorluklar yaşanıyor.","Spesifik gastrointestinal cerrahi gelişmiyor ve mültidisipliner çalışmaya inanılmıyor.","Protokol takipleri yok, sosyal güvenlik kurumu bu konuya kar-zarar ilişkisi ve gazete seviyesinde ilgileniyor."]},"beginTime":1224,"endTime":1295,"href":"/video/preview/4352043836254308132?parent-reqid=1765311839142448-3479536946384710975-balancer-l7leveler-kubr-yp-klg-225-BAL&text=T%C3%BCrk%C3%A7apar+Bariatrics+-+Obesity+Surgery&t=1224&ask_summarization=1"},{"index":18,"title":"Bariatrik Cerrahinin Hedefi","list":{"type":"unordered","items":["Konuşmacının asistanı Profesör Doktor Acar Tüzüner Altan, kilo mücadelesi yaşamış ve sonunda ameliyat olmuş.","Bariatrik cerrahinin hedefi, hayatına anlam verebilen insanlar yaratmak.","Ameliyat sonrası sadece kilo veren değil, hayatına yeni bir anlam katmış, ağırlık çalışmalarını 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Sunumcu Ahmet Hoca (28 yıllık deneyime sahip bir cerrah), ekibinin diğer üyeleri olan Ozan Şen, Nuran Türkçepar, Göknel Dumanlı, Ezgi Deveci, klinik sekreteri Hatice, takip hemşiresi Nazlıcan ve kreatif direktör Berk Özerk tanıtılmaktadır.","Video, obezite cerrahisi sonrası takip sürecini ve ekibin bu süreçteki rolünü anlatmaktadır. Ekibin multidisipliner yapısı vurgulanarak, hastaların obezite sonrası yaşanan dahili problemleri, mikrobiyota değişiklikleri ve yeme-içme bozuklukları gibi konularda nasıl desteklendikleri açıklanmaktadır. Ayrıca, reflü ameliyatları sonrası kusma endişesi ve obezite ameliyatları sonrası sarkma endişesi gibi konular da ele alınmaktadır.","Sunumda mikrobiyota konusunun obezite cerrahisindeki önemi ve gelecekte bu konudaki araştırmaların önemi de vurgulanmaktadır. 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