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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 7/2011

01-10-2011 | Review Article

Metabolic surgery—principles and current concepts

Authors: M. Gass, C. Beglinger, R. Peterli

Published in: Langenbeck's Archives of Surgery | Issue 7/2011

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Abstract

Introduction

In the almost six decades of bariatric surgery, a variety of surgical approaches to treating morbid obesity have been developed.

History and evolution

Rather than prior techniques being continually superseded by new ones, a broad choice of surgical solutions based on restrictive, malabsorptive, humoral effects, or combinations thereof, is now available. In fact, in recent years, the advent of surgically modifying human metabolism promises new approaches to ameliorate traditionally medically treated metabolic entities, i.e., diabetes, even in the non-obese. The understanding of the various metabolic effects have led to a paradigm shift from bariatric surgery as a solely weight-reducing procedure to metabolic surgery affecting whole body metabolism.

Conclusion

The bariatric surgeon now faces the challenge and opportunity of selecting the most suitable technique for each individual case. To assist in such decision-making, this review, Metabolic surgery—principles and current concepts, is presented, tracing the historical development; describing the various surgical techniques; elucidating the mechanisms by which glycemic control can be achieved that involve favorable changes in insulin secretion and insulin sensitivity, gut hormones, adipokines, energy expenditure, appetite, and preference for low glycemic index foods; as well as exploring the fascinating future potential of this new interdisciplinary field.
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Metadata
Title
Metabolic surgery—principles and current concepts
Authors
M. Gass
C. Beglinger
R. Peterli
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 7/2011
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-011-0834-3

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