Is Robotic Bariatric Surgery Better? Pros, Cons & What Patients Should Know

Robotic bariatric surgery provides modern precision for procedures to lose weight such as laparoscopic gastric bypass and gastric sleeve surgery, but it is not unrivaled to traditional laparoscopic procedures. According to studies, this surgery is known to have advantages in certain aspects, though superior to traditional laparoscopic methods. Recent studies highlight potential benefits in certain outcomes, though the procedure cost and operative duration are still open for discussion. Patients must take these aspects into consideration to keep good health. 

Overview of Bariatric Surgery 

Bariatric surgery is the process of altering the digestive system to take care of type 2 diabetes and obesity by cutting down on certain foods, controlling hunger by modifying gut hormones , and decreasing absorption of nutrients. This is helpful for weight loss and it boosts metabolism. When an individual needs an alternative to exercise and diet, this procedure works. 

In this process, the root cause of being overweight and the exact problem for low metabolism is assessed and analysed through Roux-en-Y gastric bypass. RYGB redirects the small intestine and stomach. Sleeve gastrectomy eliminates 80% of the stomach to cut down on hunger hormones. 

The key difference between robotic surgery and laparoscopic methods is their technique. These are all less-invasive techniques and they are easier when compared to open surgeries. In addition, they take less time to recover as well. 

For an individual to be eligible for robotic bariatric surgery, the BMI must be above 40. If it is more than 35 then it should be accompanied by other conditions such as sleep apnea or hypertension. With both the BMI’s, the success rate is 50-70%

Eligibility typically requires a BMI over 40, or over 35 with comorbidities such as hypertension or sleep apnea. Initially, there will be over 50-70% extra weight loss, however, this can be sustained effectively only based on healthy changes in one’s lifestyle. 

Robotic Technology – What You Should Know?

Robotic bariatric surgery uses a surgeon-controlled da Vinci system, which is enabled with 3D-HD visualization, filtration from tremors, instruments that work like a human hand, and offers a deep view that can help provide intricate details of the anatomy. The surgeons use a console to reduce weakness and in a 540-degree angle, it does perfect stitching taking control of all the movements. This robotic set-up has relevance in revisional surgery and multiple other bariatric procedures. 

Advantages of Robotic Bariatric Surgery

As a complex weight loss procedure, offering medical benefits equally expensive like laparoscopy, there are certain other advantages to learn about

More Visual & Precise

The primary benefits of robotic systems are magnification and enhanced 3D visualizations that enable surgeons to find out about small blood vessels, dissection of tissues, suturing, neural structures identification, en-routing deep anatomy with immense confidence. 

This kind of procedural treatment is most useful for patients with high-BMI, thick abdominal walls, and those having visceral fat.

Also Read:All About Robotic Surgery – Dr. Vikas Singhal

Precision Instrument Management

When you look at laparoscopic tools they do not provide flexibility like robotic wristed instruments do and offer freedom to move. Having this feature helps with boosting accuracy while making connections surgically, decreases trauma of inadvertent tissues, and improves the result of follow-up weight loss surgery.

Minimizes Risk Of Bleeding and Complications

Certain studies claim that assistance from robots decreases complications that might arise during surgery such as loss of blood, infections on the surgical area, requirement of transfusions, lesser chances of turning into an open surgery, requirement of transfusions. Having said that, these studies are not definite among all the other research done, however, they show great advantages in certain medical circumstances.

Consideration Of Human Aspects During Surgery

The surgeons need to be seated while performing a robotic bariatric surgery as the consoles are made in such a manner. This is one way of ensuring the surgeon is comfortable in terms of elimination of fatigue, tremor in the hands, and can avoid mistakes that are mainly caused due to the length of procedures. This directly won’t do wonders, but it helps maintain quality and performance in the case of difficult cases. 

Tiny Scars and Quick Recovery

As robotic surgery is less painful and focuses on precision, it is possible for patients to get small cuts, experience slight pain after the operation, with this procedure there is no long stay at hospitals, and one can return back to normal activities quickly. These are some of the basic benefits of less painful surgeries and are not any different from other procedures.

Disadvantages of Robotic Bariatric Surgery

As mentioned earlier, robotic bariatric surgery too has a few shortcomings despite displaying a fair share of advantages. Here’s why this surgery cannot be a preferred choice for every patient 

1. Expensive

Robotic procedures are high-priced and can go up to dollars. Besides, it needs to be maintained continuously, expert instruments need to be utilized, and the staff need to stay updated with training. All put together, it is not budget-friendly. Based on the policy and location, even if you consider insurance, the entire cost cannot be insured. 

1. Extended Duration

At times, in some cases the surgeries take longer than usual if there is not enough staff to handle technology. Another disadvantage tied to this is an increased anesthesia time can increase the risk for a few patients.

1. Lack of Experience 

Learning robotic surgery needs committed training. Experts with not much experience might not receive the perks of it at first. On the other hand, it is crucial for the entire team to have the right knowledge to use the system, if achieving long-term benefits is the goal. 

1. Technical Constraints

With robotic surgeries, surgeons are unable to feel and get to truly understand tissue resistance. Unlike laparoscopic surgeries, where the surgeons can feel the tension, here it is all handled by robots and can be a limitation for doctors to be able to connect. 

1. Divergent Results

According to studies, several aspects such as providing weight loss guarantee, treating other possible complications, and receiving long-lasting solutions from a robotic surgery is similar to that of what you get from a laparoscopic procedure. Furthermore, studies suggest that patients who get a robotic surgery done are likely to come back for another procedure and complications might arise. 

Robotic Bariatric Surgery – Whom Is It Most Useful For?

Robotic bariatric surgery could be beneficial for:

1. Recurring Cases

Those patients who need to perform bariatric surgery another time to make certain changes from the procedure earlier, can go in for it. Generally, precision later on is guaranteed. For instance, those who have a scar might find it challenging in navigating the new anatomy. Therefore, robotic systems come into the picture. 

1. Patients Who Are Highly Obese

When it comes to patients with high BMI levels, performing a robotic surgery helps surgeons face challenges better when compared to doing a laparoscopic surgery.

1. Robotic Trained Specialists

Getting the surgery done from a surgeon with the right expertise to offer positive results is essential, the surgeon must know how to handle the robot. At the same time, the surgeon’s knowledge in bariatric surgery should be strong as well. Therefore, both knowledge and skill to be hands-on with robotic procedures have their own relevance. At times, a laparoscopic surgeon ends up doing better than the outcomes derived out of robotic technology.

Important Questions Before Choosing Surgery 

It is a massive decision to choose a bariatric procedure. Ensure to ask some of these important questions before you make a wise choice. 

• Surgeon Details

Always ask the surgeon about the number of robotic bariatric surgeries performed, number of complications witnessed during laparoscopic and robotic procedures, and if he has a certification in robotic surgery. 

• Availability of Facilities

Check what kind of facilities are provided during the hospital stay, their action plan of post-recovery treatment, and the percentage of requests for bariatric procedures on a day-to-day basis.

• Cost & Insurance

Analyse the difference in the cost of a laparoscopic procedure and robotic surgery. Check if the expenses for a robotic surgery can be insured. If yes, then how much.

Robotic Bariatric Surgery – Is It A Better Choice?

By all means, robotic bariatric surgery is not always the best choice. However, it offers other excellent benefits that cannot be ignored either. Therefore, it depends on the patient’s expectations, budget, availability of time, and comfort. 

If you need to get operated in situations of getting a surgery done the second time due to complex anatomy and for precision, then this is better. From a surgeon’s standpoint, it decreases surgeon fatigue, offers 3D visualization, and possibilities of encountering a few complications due to lack of procedural knowledge in bariatric robotics.

Also note, robotic bariatric surgery takes a longer time to be completed and it is expensive with lack of tactile feedback. 

Also read: Meet Dr. Vikas Singhal: Best Bariatric Surgeon in Delhi

Key Takeaway 

Robotic bariatric surgery is a dynamic option in expert centres where there are knowledgeable as well as experienced surgeons. That being said, it does not cater to all your needs, but undeniably has excellent benefits if you are comfortable spending for the costs and finding a convincing surgeon with the right skills.