bariatric surgery

The mesentery, that humble peritoneal fold suspending the bowel and providing its blood supply, has finally been recognized as an organ.  Prof J Calvin Coffey and D Peter O’Leary , PhD in a recent article appearing in the Lancet    propose that the mesentery be recognized as an organ in its own right.   We applaud the elevation of the mesentery’s status to the 79th recognized organ in the body.  Recognizing the mesentery as an organ, is important as it allows us to study its effect on maintaining healthy or contributing to diseased states.

We have maintained that the noxious cellular hormones secreted by the mesenteric fat constitute a deadly cytokine factory responsible for Type II Diabetes (resistin), hypertension (angiotensinogen), autoimmune diseases and cancers, blood vessel inflammation (TNF, interleukin 6, PAL-1), and hunger (neuropeptide Y).  And mesenteric fat causes sleep apnea and gastric reflux simply as a result of its bulk.

For decades, surgeons have intervened to remove tumors of the mesentery or to untwist it in cases of volvulus to save compromised bowel.  However, Endcopic Visceral Lipectomy may well be the first intervention explicitly directed at the mesentery’s function as an organ to crease a diseased state, namely metabolic syndrome and Type II Diabetes.  Bravo.