Surgical treatment of obesity and metabolic disorders – new challenges for different specializations

Česká verzia

Authors: Fried M.
Authors place of work: OB klinika a. s., Centrum pro léčbu obezity a metabolických onemocnění, Praha
Published in the journal: Gastroent Hepatol 2019; 73(6): 468-471
Category:
doi: https://doi.org/10.14735/amgh2019468

Summary

Methods of bariatric and metabolic surgery have experienced major changes over the past 7 decades. One of the most important changes was the introduction of laparoscopic/minimally invasive approaches in the early 1990s, resulting in the more widespread performance of bariatric surgery worldwide. The shift from bariatric surgery to metabolic surgery is regarded as another substantial change in treatment, as the most important measure of success in metabolic surgery is the improvement or remission of metabolic parameters, such as type 2 diabetes mellitus and hypertension, rather than weight loss on its own. Despite increasing numbers of bariatric and metabolic procedures, only a small proportion of potentially eligible patients undergo these treatments. Reasons for refusal include concerns of both patients and referring physicians of the risks and excessive invasiveness of these procedures, their irreversible anatomical changes, and distrust in treatment results. New technical developments and treatment algorithms target these concerns, with the goal being to use less invasive surgical methods, and to directly involve different medical specialties and treatments. Examples include gastroenterologists performing endoscopic gastric plication or partial jejunal bypass, as well embolization of the left gastric artery. Patients generally prefer less invasive treatments, although it may result in moderate effectiveness, rather than highly infective, but highly invasive, riskier treatment.

Submitted: 3. 10. 2019

Accepted: 9. 10. 2019

Conflict of Interest: The author declares that the article/ manuscript complies with ethical standards, patient anonymity has been respected, and he states that he has no financial, advisory or other commercial interests in relation to the subject matter.

Publication Ethics: This article/ manuscript has not been published or is currently being submitted for another review. The author agrees to publish his name and e-mail in the published article/ manuscript.

Dedication: The article/ manuscript is not supported by a grant nor has it been created with the support of any company.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio medical papers.

Keywords:

bariatric and metabolic surgery – type 2 diabetes – new therapeutical approaches

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