Last month I talked about how safe weight-loss surgery has become. As equipment and techniques continue to evolve, bariatric surgery has become even more efficient and safe. In my practice, robotic surgery is now making that difference. The use of the robot in surgery is not new, as it has been used in Urology and Gynecology for years. However, the instrumentation of the robot over the years has developed to the point that it now improves bariatric surgical technique.
Robotic bariatric surgery builds on laparoscopic surgery in a few key ways: 1) improved visualization 2) precise movement of instruments and 3) the ability to monitor blood supply. All three of these factors allow the surgeon to provide a better surgical procedure.
The picture provided by the robot gives the surgeon depth perception. With laparoscopy, pictures are in a two-dimensional view so that they look just like something you would view on television. However, with the robot and its associated computer, depth perception is allowed. We can now look around the stomach, spleen, and liver, providing a more precise understanding of the anatomy. This impacts the end result in that there is less chance for error.
When I refer to more precise movement of instruments, it means that the instruments are actually controlled by the surgeon’s hands. The instruments are just an extension of our fingers, but the computers platform allows us to move our fingers and hands in a more controlled fashion. This translates into better instrument motion, allowing a more precise surgical technique.
Finally, the robot has the technology to check the blood supply to the stomach at the end of the procedure. Leaks that occur in the sleeve gastrectomy or gastric bypass happen for two major reasons; a problem with a staple or a problem with the blood supply. We have always been able to do a leak test at the end of these operations. The blood supply has been a judgement call by how it looks. Now with the robotic technology we can inject a dye into the blood stream which shows us where the blood is flowing, eliminating any guessing on the surgeon’s part.
I have been fortunate in my surgical career in that I have witnessed many great medical advances that have dramatically improved patient care–from laparoscopic cholecystectomy’s to laparoscopic bariatric surgery. Now the use of the robot in bariatric surgery is also one of those advances. Generally, the use of new technologies or products is accompanied by an increase in the cost of surgeries. But, not in this case. The use of the robot at Presbyterian St. Luke’s Medical Center has not increased the cost of surgery for patients. Just more good news!
So, if you are contemplating bariatric surgery, I strongly recommend that you consider your procedure be done robotically by an experienced bariatric surgeon. As always, if we can help answer any questions, please feel free to call us at CBSI (303-861-4505) or visit our website (www.coloradobariatric.com).
Tom Brown, MD
Colorado Bariatric Surgery Institute, Inc.