Weight loss surgery is an effective tool to help people who are severely obese and have been unable to lose weight through diet or other traditional means. Weight loss surgery procedures, also called bariatric surgery, have evolved in recent years. From traditional open procedures to minimally invasive laparoscopic surgery, the options for weight loss surgery have grown. The latest option for weight loss surgery is robotic surgery.
Robotic surgery uses new technology to perform operations with smaller incisions. The surgeon sits at a console in the same room as the patient and controls the arms of the robot to perform the operation. The robot has 3D cameras that provide a very clear view for the surgeon. An expert team joins the surgeon and patient in the operating room to assist with the surgery. Washington University bariatric surgeons perform weight loss surgery using a robotic, laparoscopic or open approach, depending on the patient and procedure. Each patient is evaluated individually to determine the best surgical treatment for them.
Pros and Cons of Robotic Weight Loss Surgery
Robotic weight loss surgery has many benefits for both the surgeon and the patient.
Pros:
- Better vision: The robot has 3D visualization, which increases depth perception and provides a clear view for the surgeon.
- Smaller incisions: The incisions made in robotic surgery are less than one-third of an inch long. These smaller incisions hurt less and heal more quickly than the larger incisions used with open surgery. Robotic surgery leaves fewer visible scars and reduces the risk of infection.
- Better range of motion: Robots used for surgery have wrists that can bend and move, and their instruments provide a broader range of motion than laparoscopic instruments.
- Better ergonomics: The robot allows the surgeon to sit at a console with controls within easy reach. This prevents physician fatigue and offers more precise positioning during the procedure. Using the robot also makes it easier for the surgeon to reach parts of the anatomy that can be difficult to reach.
- Shorter hospital stays and recovery times: This minimally invasive approach will often mean less time in the hospital, less pain and a quicker return to work for patients.
Cons:
- The learning curve: Robotic surgery uses newer technology. This means that not all surgeons have trained with the technology. Washington University bariatric surgeons are fellowship-trained and maintain their skills through simulation training.
- No haptic feedback: With robotic surgery, the surgeon sits at a console and controls the robot, which is at the patient’s bedside. The surgeon does not feel the instruments touching the tissue. This makes it important for the surgeon to use visual cues, understand anatomy and have familiarity with the robotic approach.
Procedures Offered Robotically
Gastric Bypass
In gastric bypass, the surgeon uses surgical staples to divide the stomach and create a small upper pouch about the size of a golf ball. The intestine is then divided and brought up to the small stomach pouch, bypassing the lower part of the stomach.
Sleeve Gastrectomy
In sleeve gastrectomy, the surgeon removes a large portion of the stomach in a vertical fashion, leaving the organ about the size and shape of a banana or sleeve. After sleeve gastrectomy, the stomach holds about one-tenth its previous capacity. The procedure restricts the amount of food a person can eat before feeling full, but does not decrease the absorption of food.
Duodenal Switch
In biliopancreatic diversion with duodenal switch, a less common procedure recommended for people with a body mass index (BMI) greater than 50, there are two components. First, a smaller stomach pouch is created by removing about 60-70% of the stomach. Then the duodenum, the first part of the small intestine, is divided just past the outlet of the stomach. The surgeon also divides the last portion of the small intestine, and the remaining segment is and connected to the outlet just below the new stomach. About three-fourths of the small intestine is bypassed by the food stream.