Totally Robotic Roux-en-Y Gastric Bypass. A Step by Step Approach
Posted in Lectures on 13 November 2018
Director of the Colorectal Cancer Unit at I.C.O.
Instituto CUF de Oncologia
The prevalence of obesity in developed countries has nearly doubled since 1980. In 2015, the World Health Organization estimated that there were more than 700 million obese adults worldwide. Bariatric surgery has been shown to be a clinically and cost-effective intervention for moderately to severely obese people compared to non-surgical interventions. Bariatric operations are currently among the most frequently performed procedures in the United States and Europe. Although the Sleeve Gastrectomy has become the most commonly performed procedure, the Roux-en-Y Gastric Bypass (RYGBP) is still the gold standard.
Obese patients have benefited from minimally invasive surgery, with laparoscopy being the recommended approach for performing a RYGBP. However, despite the advantages of laparoscopic surgery, there are limitations, such as a two-dimensional view and restrictions in the range of movements. The robotic approach makes it possible to work in three-dimensional views, with endowristed instrumentation, and with a stable camera platform. This may translate into very precise surgery. It also allows for a secure manual gastrojejunal anastomosis, which Prof. Carlos Vaz believes is safer than the mechanical one.
The RYGBP is a standardized procedure, with clear and identified steps. In this lecture, Prof. Carlos Vaz describes the robotic approach to the procedure on a step-by-step basis, highlighting the possible advantages that this platform provides.