Common Questions Regarding Robotic Bariatric Surgery
I’m just getting back from the annual ASMBS (American Society of Metabolic and Bariatric Surgery) meeting. Once a year bariatric surgeons and bariatric medical doctors gather to exchange new ideas about the medical treatment of obesity, as well as surgical techniques now being utilized for weight loss. This year, one of the major sessions was addressing robotic bariatric surgery. The consensus at this meeting was that robotic bariatric surgery is here to stay, and we will undoubtedly experience a sharp increase in robotic bariatric procedures being performed. I would like to share with you some of the questions I commonly get from my patients, as well as questions from other surgeons concerning robotic bariatric surgery.
Why don’t all bariatric surgeons do robotic procedures?
There are several parts to this question. First, surgeons need to see results for the procedure—confirm that they are safe, effective, cost effective, and provide good outcomes. The data shows that the robotic bariatric procedures are safe, have good outcomes, and may cost a bit more than laparoscopy, but with decreasing costs being realized over time.
Second, the surgeons need to get trained with the robot to proficiently perform these procedures. It involves simulators to become familiar with the robot, then labs to learn the techniques for the procedures, and finally doing the first few cases with a proctor to ensure safety for the patient. This process for me lasted over a 6-month time period of dedicating myself to several hours a week for proper training. The good news is that surgery residents are now receiving robotic training as part of their education, so shortly we’ll have many skilled robotic surgeons.
Why is the robotic technology superior to the laparoscope?
First, we will examine the scope. The visualization with the laparoscope compared to the robotic scope is like comparing a black and white television to an HD television. The robotic scope is three dimensional and gives the surgeon depth perception making it a more precise picture. In addition, the robot gives the surgeon feedback—both visual and audible—to signal when a task is safe and complete. One example of this: the robot measures the thickness of the tissues before it fires the stapler. If the tissue is too thick, it alerts the surgeon to use a different stapler. In contrast, the laparoscopic stapler relies on the surgeon’s judgement to determine if the tissue thickness is sufficient.
Another example where the robot is advantageous: the electrocautery device makes a sound to confirm its job is complete. This indicates that it is safe to divide the blood vessels which leads to less bleeding, which is always a good thing.
Finally, I’ll share a question I’m getting more and more from my patients.
Will you promise me you will do my surgery using the robot?
My answer—absolutely! I have completed almost 1,000 robotic bariatric procedures with good weight loss results, and resolution or improvement of co-morbidities like type II diabetes, hypertension, and obstructive sleep apnea. I would want nothing less for my patients.
So, what I learned from my recent meeting is that robotic bariatric surgery, is indeed, the future of bariatrics. Please call our office (303-861-4505) if you would like to schedule a consultation or visit our website www.coloradobariatric.com for more information. We are here to assist you with your weight loss goals in achieving a happier and healthier life.
Dr. Tom Brown
Colorado Bariatric Surgery Institute