Innovative metabolic operations

Surg Obes Relat Dis. 2016 Jul;12(6):1247-55. doi: 10.1016/j.soard.2016.02.034. Epub 2016 Mar 3.

Abstract

Bariatric surgery was developed with the aim of weight reduction. Success was defined only by excess weight loss. Other indices of resolution of metabolic co-morbidities were reported but were mostly secondary. Several communications have reported that regardless of body mass index (BMI), complete or partial remission of type 2 diabetes (T2D) is possible with such traditional gastrointestinal operations as the Roux-en-Y gastric bypass, bileopancreatic diversion, and sleeve gastrectomy. These results mostly occur before weight loss, positioning metabolic surgery as a good tool for controlling the current T2D epidemic. Surgery aimed mainly at the diseases, such as diabetes, and not weight loss are referred to as metabolic surgery. Metabolic surgery can effectively treat T2D in individuals with any BMI, including that below 35 kg/m(2). Concurrently, some new procedures were developed to treat patients that in theory do not need massive weight loss, focusing on a pathophysiological approach to T2D. Those new techniques, mainly duodenal jejunal bypass, ileal transposition, single-anastomosis duodenal ileal or jejunal bypass with sleeve gastrectomy, and the endoscopic duodenal liner, are experimental procedures, most reporting good metabolic control initially without relation to weight variation.

Keywords: Bariatric surgery; Duodenal jejunal bypass; Gastrointestinal surgery; Ileal transposition; Innovative metabolic procedures; Metabolic surgery; Obesity; Type 2 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Anastomosis, Surgical / methods
  • Bariatric Surgery / methods*
  • Bariatric Surgery / trends
  • Diabetes Mellitus, Type 2 / surgery*
  • Duodenum / surgery
  • Humans
  • Ileum / surgery
  • Jejunum / surgery
  • Laparoscopy / methods
  • Metabolic Syndrome / surgery
  • Obesity / surgery
  • Therapies, Investigational / methods*
  • Treatment Outcome