Bariatric Surgery

The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch.[1]  Each procedure is different, but very generally can be described as procedures that cause weight loss by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption.

Roux-en-Y gastric bypass (RYGB) is one type of bariatric surgery that is commonly used. It is often done as a laparoscopic surgery, with small incisions in the abdomen.

 

Figure 1. Open vs Robotic, Port Placement for Gastric Bypass

This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. This is done by stapling off the upper section of the stomach which reduces the amount of food you can eat. The surgeon will then attach this pouch directly to part of the small intestine called the Roux limb, forming a “Y” shape. Any food that is eaten then bypasses the rest of the stomach and the upper part of your small intestine. This acts to reduce the amount of fat and calories you absorb from the foods you eat. It also reduces the amount of vitamins and minerals you absorb from food.[2]

Learn more about what robotic assisted surgery is and how surgeons use the technology here.

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Losing for a better life

Montreal Sacre-Coeur Hospital Foundation, 2015

Potential Benefits​

Studies conducted on robotic assisted bariatric surgery have reported the following benefits:

  • Patients experience complications after surgery at a similar, though sometimes lower, rate as patients who had a laparoscopic procedure.[4-13]
  • Patients experience complications during surgery at a similar rate as patients who had a laparoscopic procedure.[4,5,6,9,11,12]
  • There is a similar, though sometimes shorter, length of stay in hospital compared to laparoscopic surgery.[3,4,7,8,9,10,11,12,13]

Additional Patient Resources

Visit the Obesity Canada for more information including frequently asked questions, how to prepare for surgery and what to expect after surgery.

 

Educational Videos

Learn more about Ragean and Lisa’s experiences with robotic-assisted gastric bypass surgery. Hear from their surgeon, Dr. Curtis Peery, about what robotic-assisted bariatric surgery with a da Vinci surgical system means.

Dr. Ronald Denis and his patients discuss obesity and treatment including robotic-assisted bariatric surgery. [French]

Risks & Considerations

 Not everyone is a candidate for robotic assisted procedures, and other treatment options may be available and appropriate. Only a doctor can determine whether robotic assisted surgery is appropriate for a patient’s situation. Surgery of any form contains risks and it is important to discuss risks with your provider. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision. 

Patients have also developed support areas where they are able to speak with each other about the surgery, their experiences, and any issues that they have faced during their treatment. To learn more check out the additional resources above or visit the community section of this website. 

[1] https://asmbs.org 

[2] https://www.hopkinsmedicine.org

[3] Bariatric Surgery in Class I Obesity Published September 2012 (… the laparoscopic approach has largely replaced open surgery…)

[4] Ahmad, A., Carleton, J.D., Ahmad, Z.F. et al. Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital. Surg Endosc. 2016 Sep;30(9):3792-6. doi: 10.1007/s00464-015-4675-y.

[5] Ayloo, S., Roh, Y., Choudhury, N. Laparoscopic, hybrid, and totally robotic Roux-en-Y gastric bypass. J Robot Surg. 2016 Mar;10(1):41-7. doi: 10.1007/s11701-016-0559-y.

[6] Benizri, E.I., Renaud, M., Reibel, N. et al. Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study. Am J Surg. 2013 Aug;206(2):145-51. doi: 10.1016/j.amjsurg.2012.07.049.

[7] Myers, S.R., McGuirl, J., Wang, J. Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes. Obes Surg. 2013 Apr;23(4):467-73. doi: 10.1007/s11695-012-0848-0.

[8] Smeenk, R.M., van ‘t Hof, G., Elsten, E. et al. The Results of 100 Robotic Versus 100 Laparoscopic Gastric Bypass Procedures: a Single High Volume Centre Experience. Obes Surg. 2016 Jun;26(6):1266-73. doi: 10.1007/s11695-015-1933-y.

[9] Stefanidis, D., Bailey, S.B., Kuwada, T. et al. Robotic gastric bypass may lead to fewer complications compared with laparoscopy. Surg Endosc. 2018 Feb;32(2):610-616. doi: 10.1007/s00464-017-5710-y.

[10] Wood, M.H., Kroll, J.J., Garretson, B. A comparison of outcomes between the traditional laparoscopic and totally robotic Roux-en-Y gastric bypass procedures. J Robot Surg. 2014 Mar;8(1):29-34. doi: 10.1007/s11701-013-0416-1.

[11] Buchs, N.C., Azagury, D.E., Pugin, F. et al. Roux-en-Y gastric bypass for super obese patients: what approach? Int J Med Robot. 2016 Jun;12(2):276-82. doi: 10.1002/rcs.1660.

[12] Buchs, N.C., Morel, P., Azagury, D.E. et al. Laparoscopic versus robotic Roux-en-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014 Dec;24(12):2031-9. doi: 10.1007/s11695-014-1335-6.

[13] Hagen, M.E., Pugin, F., Chassot G. et al. Reducing cost of surgery by avoiding complications: the model of robotic Roux-en-Y gastric bypass. Obes Surg. 2012 Jan;22(1):52-61. doi: 10.1007/s11695-011-0422-1.