Robotic Bariatric Surgery

What is Robotic Bariatric Surgery?

Bariatric surgery, also called weight loss surgery, is a surgical treatment for people with obesity to lose weight and improve their quality of life. The term "bariatric surgery" can be used to describe a variety of procedures, such as gastric bypass, sleeve gastrectomy, and other weight loss surgeries that help in weight loss by making changes to the digestive system. Bariatric surgery can be performed as open surgery with a large incision or as a minimally invasive surgery with small incisions.

Robotic bariatric surgery is a minimally invasive weight loss surgery that is performed by your surgeon with the help of robotic arms that hold and manipulate surgical instruments.

Robotic bariatric surgery is comparatively similar to laparoscopic surgery since both use small incisions, surgical instruments, and a camera. However, they differ in how the surgery is carried out. The robotic surgery technique is performed by a surgeon who has been specially trained to use the technologically advanced robotic surgical system.

Indications for Robotic Bariatric Surgery

Robotic bariatric surgery may be recommended when diet, exercise, or medications have not helped in reducing your weight. It  is indicated for people with a BMI of 40 or more, and also in those whose BMI is 35 to 39 that are suffering from obesity-associated health conditions such as:

  • Type 2 diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Sleep apnoea
  • Non-alcoholic fatty liver disease

Preparation for Robotic Bariatric Surgery

In general, preparation for robotic bariatric surgery may involve the following steps:

  • A review of your medical history and a physical examination are performed to check for any medical issues that need to be addressed prior to surgery.
  • Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
  • You will be asked if you have allergies to medications, anaesthesia, or latex.
  • You should inform your doctor of any medications or supplements that you are taking or any medical conditions you have such as lung or heart disease.
  • You may be asked to stop taking certain medications, such as blood thinners, anti-inflammatories, aspirin, or other supplements for a week or two.
  • You should refrain from alcohol and tobacco at least a few days prior to surgery and several weeks after, as it can hinder the healing process.
  • You should not consume any solids or liquids at least 8 hours prior to the surgery.
  • You should arrange for someone to drive you home after the surgery.
  • A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.

Procedure for Robotic Bariatric Surgery

The most common types of bariatric surgery include gastric bypass, sleeve gastrectomy, adjustable gastric band, and duodenal switch. Your surgeon may perform any of these surgeries using a robotic system based on your surgeon’s preference and what is best for your condition. Bariatric surgeries function in different methods, whether by limiting the quantity of food your stomach can hold, reducing the body’s ability to absorb nutrients or a combination of the two. The surgery is typically performed under general anaesthesia.

The robotic system consists of a surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance vision system (3D camera), and miniaturised surgical instruments. While performing the bariatric surgery, your surgeon will be seated at the surgeon’s console and is able to view a magnified, high-resolution 3D image of the area to be operated on. Your surgeon will be able to see the internal structures of the abdomen on a monitor with images sent from the camera. To access the surgical site, your surgeon introduces miniaturised instruments through small incisions in your abdomen. These instruments help your surgeon perform the procedure with precision and control. Your surgeon uses master controls that function similarly to forceps and in turn, the robotic arms respond by immediate translation of the surgeon’s directions into precise movements of the surgical instruments and make required changes to your digestive system as per the type of bariatric surgery performed. The goal of the surgery is to help lose large amounts of weight by making you feel full quicker with less food, thereby limiting your calorie intake, and absorbing fewer calories by the modifications made in the digestive system.

Postoperative Care and Recovery

After the surgery, you are required to stay in the hospital for about 2 to 3 days. You will be given pain medications to keep you comfortable and antacids to reduce the amount of acid produced by your stomach. Your nurse will help you to move at the earliest after the surgery to prevent blood clots, respiratory problems, and bedsores. You will be kept on a liquid diet for the first 2 weeks. Your surgeon or dietician will give you a specific diet plan and instructions to follow after the surgery. It is important to drink plenty of fluids throughout the day to avoid dehydration. Refrain from smoking and alcohol for a specific period of time as it can hinder the healing process. Refrain from strenuous activities and lifting anything heavier than 5 pounds for a defined period. Refrain from driving until you are fully fit and receive your doctor’s consent. A follow-up appointment will be scheduled to monitor your progress.

Benefits of Robotic Bariatric Surgery

Compared to conventional weight loss procedures, robotic bariatric surgery may offer several benefits, such as:

  • Smaller incisions
  • Minimal bleeding
  • Quicker recovery
  • Minimal muscle trauma
  • Lower infection rates
  • Shorter hospital stays
  • Fewer complications
  • Reduced pain and scarring

Risks and Complications

Robotic bariatric surgery is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as:

  • Internal bleeding 
  • Infection
  • Nausea and vomiting
  • Dehydration
  • Nutritional deficiencies
  • Leakage of gastric content
  • Damage to adjacent organs
  • Deep vein thrombosis (blood clot in the leg)