Bariatric surgery is well recognized for inducing dramatic weight loss in morbidly obese individuals. Over time, however, clinical evidence has shown that this particular surgery is also beneficial for certain metabolic and neuroendocrine conditions. As a result, traditional bariatric surgery has provided the rationale for a new and distinct surgical model, which is known as “metabolic surgery.”
The primary goal of the new model is to prevent, treat, improve or ameliorate Type 2 Diabetes and other metabolic syndrome conditions. In contrast, inducing weight loss is the primary aim of traditional bariatric surgery.
Types of Metabolic Surgical Methods
There are several metabolic surgical procedures in use today, and others are on the horizon. Thanks to laparoscopy, most of the surgeries are safe, less invasive and require fewer incisions, which leads to less pain, discomfort and shorter hospital stays. Additionally, even individuals who are 55 years old and older can enjoy the benefits (Chih¬Kun Huang, Amit Garg, Hsin-Chih Kuao,Po¬Chih Chang and Ming¬Che Hsin, 2015).
According to Rubino (2013), some of the common methods that improve or resolve the risk factors of metabolic syndrome are:
• Roux-en-Y gastric Bypass (RYGB)
• Sleeve gastrectomy (SG)
• Biliopancreatic diversion (BPD)
• Laparoscopic adjustable gastric banding (LAGB)
• Duodenaljejunal bypass (DJB)
Newer no-incision through the mouth metabolic surgeries for T2DM include Transoral gastroplasty (TOGA), which is a technique that is currently under clinical trial, and the Endobarrier Sleeve, which is an evidence-based and successful method. Other procedures include Ileal Interposition (II), Ileal Interposition in combination with Sleeve Gastrectomy (IISG) and Diverted Sleeve Gastrectomy (IIDSG).
According to Payab and Hasani-Ranjbar (2015), these procedures are not limited to sufferers of morbid obesity but are also used for non-obese individuals with T2DM. In these surgeries, the upper part of the stomach is removed. Additionally, through a surgical repositioning method, a section of the ileum is removed and shifted to either the duodenal or the jejunal areas. This combination leads to a decrease in the hormone Ghrelin that is associated with insulin resistance. Plasma glucose levels are also decreased.
In conclusion, according to Laing (2015), current metabolic surgical procedures are safer and have very low morbidity and mortality rates. Furthermore, clinical evidence supports their positive benefits. As with all surgical procedures, however, there are associated risks involved. That is why it is extremely important that individuals thoroughly research each procedure and discuss them fully with their healthcare providers to determine which approach is best for their particular situation.