The first surgery developed for the treatment of the type 2 diabetes with surgery is ileal interposition surgery. As a result of the studies conducted, the incretin effect of the hormones secreted from the last part of the small intestine has been noticed. 

Here it is, the basic logic of the ilial interposition surgery has been based on this basis. It has been aimed that the hormones, such as GLP-1, which are secreted from the last part of the small intestine and which effectively control the blood sugar during the transition from the stomach to the small intestine, meet these hormones without giving opportunity to rise quickly of the blood sugar level with the carbohydrates. This is why in the ileal interposition surgery, bringing the last part of the small intestine closer to the stomach by proximalizing it constitutes the most important step of the surgery.

The ileal interposition surgery has been developed for the Type 2 diabetes patients. Unfortunately, the patients with the Type 1 diabetes are not suitable for this surgery. The type 2 diabetes patients, whose insulin reserve is sufficient as a result of the tests conducted, are candidates for this surgery regardless of their obesity status.

In the ileal interposition surgery, it is aimed primarily to quickly empty the food from the stomach and to deactivate the hormone active region of the stomach by reducing the stomach volume. Then, the ileum is proximalized and it is allowed the food to meet with the insulin-like hormones as soon as possible.

The surgery is performed by the laparoscopic or robotic method. The average surgery series is 2-3 hours in our series. The patients are discharged after being followed up in our service for 3-4 days after the surgery.

Its advantages

❖ The obesity condition is not required for the ileal interposition surgery. It can be easily applied to the patients who are of all weights.

❖ When the ileal interposition surgery can be performed with the closed method, the postoperative recovery period is short.

❖ In the postoperative period, the blood sugar control is provided without the need for the insulin injection that the patients usually use.

❖ The surgery provides significant benefit for not only to the diabetes but also to other components of the metabolic syndrome.

Its disadvantages

❖ The surgery is an advanced laparoscopic surgery and it is difficult to perform and the surgery time is longer than other surgeries.

❖ Even if various effects are observed due to digestive system changes in the post-operative period, they can usually be eliminated temporarily and with the supplements.

Postoperative Period

In order to regulate the digestive system habits in the postoperative period of about 1 month, the transition from the liquid foods to the soup, puree and finally solid food is applied in a stepwise manner. All this information is explained in detail by our dietitian and our team. The diabetes does not disappear immediately; however, it provides protection from its negative effects from the first days. The settling of the effects of the surgery takes about 6-8 months. After the first year, the diabetes has been taken under control after the 1styear.