London Bridge Hospital Metabolic and Bariatric Centre

For patients living with T2D and obesity, we offer an alternative to long-term medication – metabolic surgery. This surgery represents a major advance in the treatment of the disease. In appropriate patients this surgery can induce powerful and sustained clinical benefits, even to the point of disease remission.

Decades of research – much of it led by Professor Rubino – have shown the drastically improved outcomes for patients living with T2D. Rather than manage the effects of the illness with lifestyle changes and medication, minimally invasive surgery is now a recommended standard treatment for the underlying metabolic disease – both internationally and in the UK, within NICE guidelines.

Since 1999, Professor Francesco Rubino has been working to treat metabolic dysfunction surgically, by altering the part of the stomach that releases hormones after eating. This has since become the basis of metabolic surgery.

Prof Rubino and his colleagues observed that, in cases of T2D and obesity, the hormones released by the stomach after eating can become overstimulated. This is part of what causes the metabolism to establish and maintain an incorrect body weight and produce unhealthy levels of the hormone that regulates blood sugar levels.

If existing bariatric procedures on the part of the stomach that produced these hormones could be used, Prof Rubino theorised that metabolic function could be improved – or even returned to normal. And the procedure itself would be minimally invasive, treating the underlying cause of T2D through an incision no wider than the diameter of a pencil.

Metabolic surgery is a keyhole procedure to reduce the surface of the gastrointestinal tract. This removes or reduces the hormones that are affecting normal metabolic function – helping the body to better regulate hunger, satiety, and hormone production.

There are four accepted surgical approaches for the treatment of T2D: Roux-en-Y Gastric Bypass, Sleeve Gastrectomy, Biliopancreatic Diversion and Laparoscopic Adjustable Gastric Banding. Two of the four surgical procedures, most often recommended, restore some or all normal metabolic function without affecting the patient’s typical digestive system, seen below.