TY  - CHAP
M1  - Book, Section
TI  - Surgical Treatment of Morbid Obesity and Type 2 Diabetes
A1  - Schirmer, Bruce D.
A2  - Zinner, Michael J.
A2  - Ashley, Stanley W.
A2  - Hines, O. Joe
PY  - 2019
T2  - Maingot's Abdominal Operations, 13e
AB  - The  surgical  treatment  of  obesity  originated  with  the  concept  that  a  surgical  intervention  to  alter  digestive  anatomy  and  physiology  could  benefit  patients  with  a  metabolic  related  disease.  At  the  University  of  Minnesota  in  the  1950s,  surgeons  performed  an  operation  to  bypass  the  distal  small  bowel  to  limit  absorption  of  lipids  in  a  patient  with  severe  hyperlipidemia.1  Over  60  years  later,  the  field  of  metabolic  and  bariatric  surgery  has  evolved  to  provide  increasingly  safe  and  effective  surgical  treatment  options  for  patients  who  suffer  the  consequences  of  severe  metabolic  disease,  such  as  type  2  diabetes  mellitus.  As  these  treatments  have  evolved,  there  has  been  a  concurrent  improved  understanding  of  the  physiology  underlying  the  diseases  being  targeted.  This  has  often  been  a  result  of  the  observations  of  treatment  effects  of  surgical  procedures.  Increased  insight  and  knowledge  have  also  arisen  as  a  result  of  trying  to  better  understand  how  these  interventions  can  be  optimally  used  for  disease  treatment.  The  comorbid  metabolic  diseases  that  arise  secondary  to  morbid  obesity  are  generally  much  better  understood  than  the  actual  disease  of  obesity  itself.  Consequently,  surgical  treatment  has  to  date  focused  more  on  the  improvements  and  resolution  of  those  diseases  rather  than  the  disease  of  obesity.  The  major  manifestation  of  the  disease  of  obesity,  weight  itself,  certainly  has  been  the  focus  of  bariatric  surgery.  However,  the  underlying  genetic,  physiologic,  and  metabolic  factors  that  contribute  to  create  the  obesity  disease  state  are  still  not  well  understood.  Hence,  surgical  therapy  has  focused  on  weight  as  the  parameter  for  treating  the  disease,  while  underlying  causes  are  still  not  directly  targeted.  Indeed,  as  investigation  continues  as  to  the  etiologies  of  the  disease  of  obesity,  surgical  therapy  may  have  a  more  limited  role  in  the  future.  However,  at  this  time  it  remains  the  single  most  effective  treatment  for  reversing  the  disease,  both  in  terms  of  the  obvious  problem  of  weight  itself  as  well  as  the  comorbid  medical  problems  that  accompany  the  disease  in  varying  frequency  from  individual  to  individual.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1160041252
ER  -