What is Robotic Bariatric Surgery
It is hard to believe that robotic surgery for the treatment of morbid obesity has been around for 20 years. The first robotic bariatric procedure was the placement of a lapband in a patient in 1999. Since then the instrumentation has improved, making it now superior to laparoscopic bariatric surgery.
In the Denver area, the majority of bariatric surgeons now use the da Vinci robot for some or all of their weight loss procedures. It is estimated that in the next 10 years, the vast majority of all surgical procedures will be completed with the help of robotics.
The advantages of the robot to the surgeons are great. Let’s go over a few of them.
Visualization: The picture delivered to the surgeon during robotics is second to none. It is a 3D, high definition image with magnification. For the first time, this gives the operating surgeon greater detail and depth perception. It allows us to see the separation between the stomach and the liver or spleen resulting in less trauma to these organs, and consequently less bleeding.
Precision: The robot provides for smooth precise movement of the instruments at the direction of the surgeon. The instruments move just like their fingers and hands which gives them the ability to place sutures in just the right places effortlessly. The robotic stapler can measure the thickness of the stomach and will only fire if we have the correct staples for the stomach thickness. In contrast, during laparoscopic procedures, the surgeon goes by what has worked in the past.
Less bleeding: The robotic electrocautery devices we use to provide feedback as to when it is safe to cut blood vessels which results in less bleeding. To illustrate this, you can click on the YouTube video below. You will see that there is very little blood loss during the procedures.
Less pain: The staples articulate to fit the tissue, as do the other instruments used robotically. This leads to less trauma to the tissues which results in less pain. I am also increasingly finding that pain is not an issue for many of my patients, with 40% not needing any opioid prescriptions postop. This is a very important distinction in this time of extreme opioid addiction.
Shorter hospital stay: Some of the more recent studies suggest a shorter hospital stay associated with robotic bariatric surgery compared to laparoscopic weight loss surgeries. In my own experience, 80% of my patients go home on day one after surgery, and almost all go home by day two.
Finally, when you choose your robotic bariatric surgeon, it is recommended that you ask the following questions:
- Which robotic bariatric procedure is the best one for me?
- Are you comfortable performing my procedure robotically?
- Can you tell me about your training and experience with the robot?
- How many cases have you done, and what are your patient outcomes with the robot?
These questions are commonly asked of surgeons, so we are comfortable answering them. For my patients, I do all of my cases robotically. I underwent very deliberate and extensive training on the robot 4 years ago, working every week in the lab for several hours until I was comfortable with the technology. Since that time, I have become the most experienced robotic bariatric surgeon in the Rocky Mountain area. I have performed more than 1,000 bariatric procedures robotically with very few complications. My patients have had excellent short-term outcomes, such as very little pain and bleeding, as well as short hospital stays. My patients have also experienced excellent long-term outcomes in achieving significant weight loss, and resolution or improvement in obesity related co-morbidities.
So, if you are considering bariatric surgery, choose wisely and have your procedure done robotically. If you have questions or would like to schedule an appointment, please call our office (303-861-4505). If you would like to check out our videos on the robotic gastric sleeve and robotic gastric bypass, the links are provided below.
Dr. Tom Brown
Colorado Bariatric Surgery Institute