Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) is used with increasing frequency for the treatment of morbid obesity. The application of robotic techniques has been reported for bariatric operations like laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding, but not for LSG. We report herein our initial experience with LSG performed with the use of the Da Vinci surgical system.
Methods
Nineteen consecutive patients underwent LSG with the use of the Da Vinci surgical system by the same surgical team. Surgical techniques followed the principles of standard LSG. Preparation of the stomach was performed by the console surgeon and its division with the staplers by the patient-side surgeon.
Results
Seventeen women and two men with a mean age of 39.4 years and a mean body mass index (BMI) of 48.2 kg/m2 were operated. Mean operative time was 95.5 ± 11.5 min. Docking time was 16 ± 4.2 min. There were no conversions. Peri-operative morbidity and mortality was zero. Time to BMI ratio for robotic LSG was 2 ± 0.3 min/kg/m2 and it was equal to the respective of our standard LSGs. When the docking time was excluded, the same ratio was 1.7 ± 0.2, significantly shorter than the respective 2.0 ± 0.5 of our conventional LSGs (p = 0.018). Mean excess body weight loss 1 year post-operatively was 65.5 ± 25.6%.
Conclusions
Robotic laparoscopic sleeve gastrectomy is a feasible, safe, and efficient surgical technique for the treatment of morbid obesity and it does not add to the operating time of the procedure.
References
Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.
Aggarwal S, Kini S, Herron D. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3:189–94.
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.
Hanly EJ, Talamini MA. Robotic abdominal surgery. Am J Surg. 2004;188(Supp):19S–26S.
Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg. 2004;188(Supp):38S–44S.
Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11:415–9.
Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech A. 2003;13:279–83.
Schauer P, Ikramuddin S, Hamad G, et al. The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc. 2003;17:212–5.
Cadiere GB, Himpens J, Vertruyen M, et al. The world’s first obesity surgery performed by a surgeon at a distance. Obes Surg. 1999;8:206–9.
Diamantis T, Alexandrou A, Pikoulis E, et al. (2010) Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopic guidance. Immediate peri-operative and 1-year results after 25 patients. Obes Surg. 2010;20(8):1164–1170.
Hubens G, Balliu L, Ruppert M, et al. Roux-en-Y gastric bypass procedure performed with the Da Vinci robot system: is it worth it? Surg Endosc. 2008;22:1690–6.
Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140:779–86.
Yu SC, Clapp BL, Lee MJ, et al. Robotic assistance provides excellent outcomes during the learning curve for laparoscopic Roux-en-Y gastric bypass: results from 100 robotic-assisted gastric bypasses. Am J Surg. 2006;192:746–9.
Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy a “food restricting” operation. Obes Surg. 2008;18(10):1251–6.
Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.
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The authors declare that they have no conflict of interest.
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Diamantis, T., Alexandrou, A., Nikiteas, N. et al. Initial Experience with Robotic Sleeve Gastrectomy for Morbid Obesity. OBES SURG 21, 1172–1179 (2011). https://doi.org/10.1007/s11695-010-0242-8
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DOI: https://doi.org/10.1007/s11695-010-0242-8