Robotic hormonal and autonomic modulation for type 2 diabetes: ileal interposition and hepatic sympathectomy.

ABSTRACT:

Background

Type 2 diabetes mellitus (T2DM) is a complex disorder involving both hormonal imbalance and autonomic dysfunction. While bariatric surgery enhances glycemic control, its effects on autonomic regulation are limited.

Objective

This is the first report describing two novel robotic surgical strategies targeting dual physiological mechanisms-hormonal modulation and sympathetic overactivity-to optimize metabolic outcomes in T2DM. The manuscript is intended to spark discussion around future surgical strategies based on two proof-of-concept index cases.

Methods

We present two patients with poorly controlled T2DM. Case 1 underwent robotic ileal interposition with sleeve gastrectomy and duodenal exclusion, aiming to enhance incretin response and reduce glucagon level

SUBMITTER: Filho AJB 

PROVIDER: S-EPMC12722888 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature