Description:

Metabolic surgery is defined as operating on a putatively normal organ or organ system to achieve a beneficial metabolic goal, mediated by neurohormonal mechanisms. This course is planned as an introduction to a discipline that is today taking its place in the surgical hegemony alongside incisional, extirpative, and reparative surgery. Metabolic surgery started in 1897 and today is best represented by bariatric surgery that ameliorates type 2 diabetes, hypertension, and hyperlipidemia, among other metabolic abnormalities, in addition to maximum weight loss. Today, extraperitoneal metabolic surgery is gaining attention (e.g., cervical single vagal stimulation for refractory depression); future metabolic surgery applications of new and standard procedures are under investigation (metabolic/bariatric surgery for traumatic brain injury). Except for trauma and infections, nearly all human afflictions are metabolic in origin and, therefore, are or can be amenable to metabolic surgery.

Learning Objectives:

1. Introduce surgeons to the concept and universal scope of metabolic surgery.
2. Place bariatric surgery appropriately in the history and outreach of metabolic surgery.
3. Discuss the metabolic mechanisms responsible for certain disease states and the ameliorating metabolic mechanisms engendered by metabolic surgery.
4. Demonstrate that metabolic thinking can unite medicine and surgery in patient therapy.