Transit bipartition surgery is a metabolic surgery method used in the treatment of obesity and type 2 diabetes. This surgery was developed to both provide weight loss and control metabolic diseases such as diabetes. Transit bipartition is based on the principle of reducing the size of the stomach and reconnecting a part of the intestines to the stomach. In this way, some of the food follows the normal digestive tract, while the other part reaches the lower part of the intestines more quickly. This process reduces the absorption of food and allows the patient to consume fewer calories.

One of the main goals of this surgery is to reduce the size of the stomach so that the person eats less and thus promote weight loss. At the same time, insulin sensitivity is increased thanks to the rearrangement of the intestines and positive effects are achieved on metabolic disorders such as type 2 diabetes.

Transit bipartition surgery is similar to sleeve gastrectomy surgery, but it differs in that the intestines are also rearranged. In other words, both the stomach is reduced and the intestines are allowed to process food in two separate ways.

Transit bipartition surgery and gastric bypass are both surgical procedures aimed at treating obesity and metabolic diseases. However, there are important differences between these two methods. Here are the differences between transit bipartition and gastric bypass:

1. Surgical Technique and Intestinal Arrangement

• Transit Bipartition: In this surgery, the stomach is reduced and a portion of the intestines are connected to the stomach, allowing food to follow the normal digestive tract and reach the lower part of the intestines more quickly. In this way, food passes into the intestines through two different paths. In other words, in transit bipartition, some of the food passes through the normal digestive tract, while the other part goes directly to the last parts of the small intestine.
• Gastric Bypass: In gastric bypass surgery, the stomach is turned into a small pouch and this pouch is directly connected to the forward part of the small intestine. This causes most of the food to completely bypass the stomach and duodenum and pass directly into the small intestine.

2. Nutrient Absorption by the Intestines

• Transit Bipartition: In transit bipartition, some of the food still follows the normal digestive tract, so absorption is not completely prevented. However, a part of the intestines comes into play and reduces absorption, which leads to less calorie intake.
• Gastric Bypass: This method reduces nutrient absorption more because it causes a large portion of the food to pass directly into the small intestines. Therefore, gastric bypass can affect nutrient and vitamin absorption more seriously.

3. Metabolic Effect and Effect on Diabetes

• Transit Bipartition: Transit bipartition can be more effective in controlling type 2 diabetes, especially thanks to intestinal regulation. This surgery provides weight loss by reducing the stomach volume and increases insulin sensitivity by rearranging the intestines. Very positive results can be achieved in the treatment of diabetes.
• Gastric Bypass: Gastric bypass also provides positive effects on type 2 diabetes, but it is not as prominent in the treatment of diabetes as transit bipartition. Nevertheless, gastric bypass surgery can significantly improve diabetes control with weight loss.

4. Nutrition and Quality of Life

• Transit Bipartition: Since the stomach is reduced in transit bipartition, the patient eats less, but since the digestive system undergoes fewer changes, the absorption of food is less affected than in gastric bypass. This can mean a better diet and quality of life for some patients.
• Gastric Bypass: Gastric bypass can lead to vitamin and mineral deficiencies, especially because a large portion of food bypasses a significant portion of the small intestine, which causes nutrients to not be fully absorbed. Patients may often need to take vitamin and mineral supplements for life.

5. Risks and Complications

• Transit Bipartition: This surgery is thought to have a lower risk of complications than gastric bypass, because a large portion of the intestines remains in place and food can follow its normal digestive tract. However, as with any surgical procedure, there are still risks.
• Gastric Bypass: Gastric bypass is a more complex procedure, so the risk of complications may be higher than transit bipartition. In particular, complications such as nutritional deficiencies, vitamin deficiencies, and intestinal obstruction may be more common.

6. Reversibility

• Transit Bipartition: Theoretically a more reversible procedure because the intestines are not completely bypassed, which may make it easier to reverse some aspects of the procedure.
• Gastric Bypass: More difficult to reverse because there is significant restructuring of the stomach and intestines.

In summary, transit bipartition surgery may be an ideal option, especially for controlling type 2 diabetes and losing weight at the same time, while gastric bypass is a more aggressive method of weight loss and has a more pronounced effect on nutrient absorption. The choice of which method to use will depend on the patient's health status, weight loss goals, and metabolic problems.

Before transit bipartition surgery, patients must undergo a comprehensive preparation process. The first step in this process is a detailed medical evaluation and examination. Your surgeon will review your health history and evaluate your current health problems, previous surgeries, and medications you are using. At the same time, your weight problems and metabolic diseases are also taken into account. If you have metabolic disorders such as type 2 diabetes, hypertension, or heart disease, the status of these disorders may affect the decision to undergo surgery.

During the medical evaluation, blood tests, heart checks such as ECG (electrocardiogram), and examinations such as chest X-rays are also performed. These tests help evaluate how suitable your body is for surgery. Your surgeon may also perform an endoscopy to examine your stomach and digestive system. These checks, which are performed to prevent potential complications during and after surgery, are very important for the success of the surgery.

The patient's psychological state is also taken into consideration during the preoperative period. Because major surgical interventions such as transit bipartition require serious changes in lifestyle. Therefore, the patient's ability to adapt to these changes and their expectations after the surgery are evaluated by a psychologist or psychiatrist. In particular, information is provided on possible difficulties that may be experienced during the weight loss process and how to organize the post-operative diet.

Pre-operative nutrition is also an important factor. It may be recommended to follow a low-calorie, high-protein diet for a few weeks before the surgery. This helps the liver shrink and makes the surgery easier to perform. At the same time, if you smoke, you should quit smoking before the surgery. Because smoking can negatively affect the post-operative recovery process and increase the risk of complications.

It is very important to follow all the recommendations given by your doctor during the preparation process for the surgery in order for the surgery to be successful and the recovery process to proceed smoothly.

Transit bipartition surgery is a very complex but effective metabolic surgery method. The surgical process is usually performed under general anesthesia and can take several hours. The first stage of the surgery begins with small incisions in the abdomen using the laparoscopic method. Laparoscopic surgery allows the surgery to be performed through small incisions instead of large ones, which shortens the recovery time and reduces the risk of complications.

First, the stomach is reduced and, similar to a sleeve gastrectomy, the stomach is reduced and turned into a tube. At this stage, the stomach volume is significantly reduced, so the patient feels full while eating less. Then, the small intestines are rearranged. A section of the intestines is connected to the stomach, allowing some of the food to pass through the normal digestive tract and the other section to pass directly to the lower intestines. This procedure causes the intestines to start processing food in two ways.

Thanks to the food reaching the intestines from two different paths, both the functioning of the digestive system is preserved and the absorption of calories and nutrients is reduced. This stage is an important feature that distinguishes transit bipartition surgery from other weight loss surgeries. During the surgery, the stomach and intestine connections allow nutrients to both follow the normal digestive tract and be partially bypassed. In this way, patients both lose weight and can control metabolic diseases such as diabetes.