The Role of Robotics in Bariatric Surgery
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BARIATRIC SURGERY (A GHAFERI, SECTION EDITOR)
The Role of Robotics in Bariatric Surgery Michelle H. Scerbo1 • Bashar Alramahi1 • Melissa M. Felinski1 • Kulvinder S. Bajwa1 Erik B. Wilson1 • Shinil K. Shah1,2
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Accepted: 2 October 2020 / Published online: 19 October 2020 Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This article will review the current evidence supporting the use of robotic platforms in bariatric surgery and discuss the technical aspects of robotic platforms in the current bariatric procedures performed. Recent Findings The use of robotic platforms for minimally invasive bariatric surgery continues to increase. This can be attributed to the perceived advantages of robotic platforms including three-dimensional high-definition visualization, tremor filtration, direct camera control by the primary surgeon, multi-quadrant access, and wristed instruments which make complex and redo surgery potentially easier to perform. Robotic systems may also provide ergonomic advantages in patients with obesity who have significant abdominal wall mass. Summary Despite a longer operative time, the preponderance of the data suggest robotic surgery is a safe and effective methodology to perform bariatric procedures. The greatest potential for clinical benefit appears to be in revisional bariatric surgery and in patients with higher body mass index. There may also be advantages in the learning curve of these complex procedures. Robotic
This article is part of the Topical Collection on Bariatric Surgery. & Shinil K. Shah [email protected] 1
Division of Minimally Invasive and Elective General Surgery, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 4.156, Houston, TX 77030, USA
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Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA
platform improvement, training, and cost-effective usage may overcome the higher initial costs. Keywords Robotics Bariatric surgery Gastric bypass Biliopancreatic diversion Metabolic surgery Gastrectomy Ergonomics
History Obesity remains one of the most challenging and growing burdens of health care in recent medicine. Almost 40% of Americans are obese, with a projected increase in prevalence by 33% by 2030 [1]. Bariatric surgery is superior to medical therapy for the treatment of obesity and its related co-morbidities [2, 3]. As a result, the number of bariatric surgeries has increased. However, bariatric surgery has evolved dramatically since first being introduced as a treatment for obesity approximately seven decades ago. The first operations, jejunoileal bypass [4], and jejunocolic bypass [5], were fraught with morbidities related to the resultant nutritional and vitamin deficiencies, as well as that of open laparotomies on patients with excess weight and significant abdominal wall mass. As we have come to understand the metabolic derangements that fol
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