The first robotic bariatric surgery performed in Thailand-surgical techniques and review of the literature

Abstract

© 2019 Faculty of Medicine Siriraj Hospital, Mahidol University. Morbid obesity is associated with multiple life-threatening comorbidities. Bariatric surgery is the most effective intervention to achieve the long-term weight loss required to reverse many of these comorbid conditions. Laparoscopic bariatric surgery is the current gold standard approach; however the robotic approach has potential intraoperative and postoperative advantages that may be realized if limitations to instrument torque effect are overcome. We review the literature about the robotic bariatric surgery and describe our first robotic sleeve gastrectomy (RSG) and a single docking operative approach to robotic Roux-en-Y gastric bypass (RRYGB) in Siriraj Hospital, and also the first in Thailand. We demonstrate the operative room setup, the port sites, the technical details, and the key step illustrations, that both operative procedures were performed using the da Vinci® Si platform. According to the literature review, a robotic approach to bariatric surgery is an alternative option with comparable outcomes to laparoscopic approach and the potential for intraoperative and postoperative advantages. It is safe, feasible, and provides good clinical outcomes that are comparable to a conventional laparoscopic method.