Robotic Gastric Bypass Surgery

A new system that allows surgeons to perform laparoscopic gastric bypass surgery from a remote console, controlling up to three robotic arms and a binocular camera, has been successfully tested in 10 patients.

The laparoscopic gastric bypass surgery, a Roux-en-Y procedure, is often considered the most challenging minimally invasive procedure in general surgery, requiring a learning curve of 75-100 cases for even experienced surgeons to achieve the highest level of proficiency. Using a technique developed to minimize robot repositioning, researchers compared their results with those of 10 patients who had undergone standard laparoscopic gastric bypass surgery. No significant differences were found in the general health, age, or body mass index of the two sets of patients. The study findings were reported in the August 2005 issue of the Archives of Surgery.

The robotic method offers a benefit specific to gastric bypass surgery: the robotic arms are strong enough to stay steady while working in the patient's massive abdomen. "The robot minimizes the torque of the abdominal wall,” explained Myriam Curet, M.D., of the Stanford University School of Medicine (Palo Alto, CA, USA). The surgeons in the study used the da Vinci robotic surgical system of Intuitive Surgical (Sunnyvale, CA, USA).

Two other advantages of robotic surgery were noted by the researchers. They found that the robotic system makes the surgery qualitatively easier, and mean surgical times were about 30 minutes shorter for the robotic surgery. Also, the robotic system has a three-
dimensional (3D) camera to aid visualization, and the system's robotic arms have highly flexible wrists, making precise maneuvers possible.

"People want to see the data and know that it is better,” said Dr. Curet, M.D. "But they seem open to it.”





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Stanford U. Medical School