Table of Contents
What is Bariatric Surgery?
Bariatric surgery, also called weight loss surgery or metabolic surgical treatment, is occasionally used as a treatment for people who are incredibly obese. It can result in considerable weight loss and also helps to improve lots of obesity-related conditions, such as type 2 diabetes or hypertension. Yet it’s a major operation as well as in many cases need to just be taken into consideration after attempting to lose weight with a healthy and balanced diet plan and also excercise.
Bariatric surgery has become a safe and effective treatment for severe weight problems, defined as BMI ≥ 40 or BMI ≥ 35 connected with obesity-related diseases. In 2019, 256,000 bariatric surgery operations have been performed in the USA, and in 2021, 22,469 bariatric surgical procedure procedures have been performed in Italy.
Who are the Candidates for Bariatric Surgery?
Weightloss surgery is advisable if:
* you have a body mass index (BMI) of 40 or more, or a BMI in between 35 and also 40 and an obesity-related condition that may resolve if you slimmed down (such as type 2 diabetes mellitus or hypertension).
* you’ve tried all other weight reduction techniques, such as dieting and workout, but have actually struggled to lose weight or keep it off.
* you accept long-term follow-up after surgical treatment, such as making healthy way of life adjustments and participating in regular examinations.
After 30 years, IFSO (International Federation of Surggery for Obesity) and also ASMBS (American Society of Metabolic and Bariatric Surgery) published a brand-new statement declaration, which lower these BMI limits according to individual information of the individuals.
What are the Kinds of Bariatric Surgery?
There are different types of weight-loss surgery. The most common types are:
* Adjustable gastric band: A silicone band is positioned around your stomach, so you do not need to eat as much to really feel full.
* Gastric bypass: The upper part of your stomach is joined to the small intestine, so you really feel full quicker as well as do not absorb as several calories from food.
* Sleeve gastrectomy: A greater portion of your stomach is removed, so you can not eat as long as you might before as well as you’ll feel full faster.
All these procedures can bring about substantial weight-loss within a few years, yet each has advantages and negative aspects. If you’re thinking about weight surgery, we will provide a visual consultation with our bariatric surgeons regarding the various kinds offered to aid choose which is finest for you.
Just How is the Life After Weight Loss Surgery?
Bariatric surgery can achieve significant weight loss, however it’s not a remedy for obesity by itself. You’ll need to devote to making permanent way of life modifications after surgical procedure to stay clear of putting weight back on. You’ll require to:.
* Change your diet plan: You’ll be on a liquid or soft food diet plan in the weeks after surgical treatment, however will certainly slowly relocate onto a normal balanced diet regimen that you require to remain on for life.
* Workout on a regular basis: As soon as you have actually recouped from surgical treatment, you’ll be suggested to begin a workout plan and also continue it for life.
* Go to routine follow-up consultations to examine how points are going after surgical treatment and obtain advice or assistance if you require it.
Females who had weight loss surgery will certainly additionally typically require to prevent conceiving throughout the very first 12 to 18 months after surgical procedure.
What are the Risks of Weight Loss Surgery?
Bariatric surgery carries a small risk of complications.These include:.
* Being left with excess folds up of skin: You may need additional surgical procedure to eliminate these.
* Not obtaining enough nutrients from your diet plan: You’ll probably need to take supplements for the remainder of your life after surgery.
* Gallstones ( actually all kinds of fast weightloss can increase the formation of gallbladder stones).
* An embolism in the leg (deep blood vessel thrombosis) or lungs (pulmonary embolism).
* The stomach band slipping out of area, food leaking from the joint in between the stomach and small intestine, or the gut coming to be obstructed or tightened.
Before having surgical procedure, our team will inform you about the possible benefits as well as risks of the procedure.
Minimally invasive bariatric surgeries have been related to enhanced very early postoperative results in comparison with open strategies, with really reduced mortality and low morbidity rates. Laparoscopic surgical procedure is presently considered the standard of care in the bariatric surgery strategy, as open surgical treatment remains only as a rescue procedure or in case of contraindications to laparoscopy.
Nevertheless, progressed laparoscopic abilities are needed to accomplish sufficient medical outcomes after laparoscopic bariatric treatments. In some conditions, such as individuals with previous abdominal surgical treatment or in complicated bariatric treatments, like biliopancreatic diversion with duodenal button (BPDDS), the laparoscopic strategy can be challenging. With this background, using the robot platform in bariatric surgical procedure has been expanding over the last twenty years.
What is Robotic Bariatric Surgical Procedure?
Minimally intrusive surgical procedure took a considerable step forward with the intro of robotically aided bariatric treatments. The da Vinci Surgical System was presented to integrate many of the benefits of open surgery (visualisation and also mastery) with those of laparoscopic surgical treatment (fewer threats as well as faster recuperation). The surgical robotic does not execute procedures by itself however is completely regulated by the specialist sitting near the operating room at a committed console.
For two decades, the robotic platform has provided surgeons much better instruments for executing minimally intrusive procedures, allowing harder procedures to be executed, from esophageal to rectal resections, including bariatric surgery. Technical benefits include tridimensional watching with a binocular electronic camera, wristed graspers, dissectors, as well as staplers, giving both boosted articulation and turning, tremor filtering system for much more specific handling, enabling hand-sewn anastomosis, causing reduced tiredness, and also enhanced medical capacities compared to laparoscopic surgery.
On the other hand, robot surgical treatment is still a topic of argument as a result of its longer knowing contour, increased prices, and also subsequently lowered cost-effectiveness.
Our facility’s skilled specialists can perform bariatric (weight loss) surgical treatment making use of a robot called the da Vinci Robotic System. Robotic surgical procedure makes use of tiny cuts as opposed to a large stomach cut and also as a result is much less intrusive than typical bariatric surgery. We have a nationwide training center for robotic weight-loss surgery using the da Vinci Robotic System. Our bariatric doctors educate surgeons throughout the Turkey.
How is Robotic Bariatric Surgery Performed?
Robotic bariatric surgery is performed by use of the da Vinci Robotic Surgery System. The da Vinci robotic is a medical support device that enables bariatric specialists to do weightloss surgery making use of computer-guided, multiplied, 3-D visualization. A surgeon will certainly navigate the robot via little incisions in the patient’s abdominal area. Using 4 robotic arms, the bariatric surgeon will certainly make motions and the robot will equate the movement right into ultra-precise motions inside your body.
Is Robotic Bariatric Surgery Much Better or Safer Than Laparoscopic Surgery?
In the hands of proficient and also experienced doctors of our center, both robot surgical treatment as well as laparoscopic surgical treatment is really risk-free and also reliable. Both have substantial advantages when contrasted to open up surgical procedure, consisting of a much shorter medical facility keep, shorter recuperation in addition to a lower threat of incisional ruptures, infection, blood loss as well as pain.
Most of the times, laparoscopic surgical procedure supplies a comparable level of safety and security and also efficiency as robotic surgery and also as such, either method can be utilized really efficiently. During appointment with our specialists, you will discover more regarding the particular benefits of your procedure as well as the method that will be used for surgery.
Who is a Candidate for Robotic Weight Loss Surgery Procedure?
Patients who are significantly obese might be candidates for robotic surgery. Seriously obese is considered any individual with a Body Mass Index of greater than 40. This converts to a person that is more than 100 pounds overweight.
You might additionally be a candidate if you have a BMI over 35 in combination with medical problems such as diabetes mellitus or high blood pressure. The enhanced visualization that the robotic system provides offers the doctor much more control over activities for the significantly obese patient.
In laparoscopic sleeve gastrectomy, the surgery is executed by developing five or 6 little lacerations to go into the abdomen. A fiber-optic device, called the laparoscope, is connected to a little camera and also is placed through the stomach wall. The device enables your cosmetic surgeon to see inside your body while performing the surgical procedure. Laparoscopic sleeve gastrectomy is then completed by linking an area of the small intestine to a tiny stomach pouch. decreases the dimension of the tummy to 30% of its original capability. In addition to limiting the amount of food you are able to consume, a lot of individuals can likewise expect much less discomfort, couple of problems, lower risk of infection and quick recuperation than standard open surgical treatment.
Robotic bariatric surgical procedure is relatively comparable to laparoscopic sleeve gastrectomy considering that both make use of tiny incisions, surgical instruments as well as a cam. Nonetheless, they vary on how the surgical procedure is performed. Robot surgical treatment technique is executed by a doctor that has actually been specially trained to make use of the technologically-advanced robot medical system.
Throughout the surgical treatment, the cosmetic surgeon will certainly make a couple of little lacerations and make use of a 3D high-definition for a multiplied view of the surgical location for enhanced accuracy and also improved visualization inside your body. The specialist is seated at a remote terminal or a console alongside the person and also runs through cuts, making use of an electronic camera as well as tiny instruments. Compared to laparoscopic surgical procedure, robotic-assisted surgical treatment supplies the specialist with a higher range of precision, motion and total effectiveness. This may cause much less blood loss, smaller sized cuts and quicker recovery for the patients.
Advantages of Robotic Gastric Bypass
The da Vinci Surgical System offers our specialists a raised sight of the tummy and bordering organs, which allows them to be extra exact and controlled in throughout surgical procedure.
Contrasted to traditional laparoscopic weight-loss treatments, robot bariatric surgical treatment may supply patients numerous potential benefits, including:.
* Quicker healing.
* Minimized pain and also scarring.
* Quicker go back to normal routine.
* Less complications.
* Much less injury to the body.
* Reduced infection rates.
* Much shorter health center stays.
* Much lower rate of intestinal leaks.
* Reduced danger of needing follow-up surgical procedure.
Robotic Bariatric Surgery: Advantages And Disadvantages.
For those that have an interest in robot surgical procedure, there are some very real advantages:.
* Greater visualisation: The da Vinci Robotic Surgical System utilises modern dual cam technology (binocular) to develop a three-dimensional sight of the medical field. The bariatric surgeon’s view from the console is magnified as well as incredibly crisp, enabling phenomenal accuracy. This is a substantial renovation over the two-dimensional sight of standard laparoscopy that, limits depth understanding.
* Smaller cuts: With only an 8 mm cut– less than 1/3 of an inch– robot surgical procedure leaves less visible marks and also minimizes the risk of infection.
* Better range of movements, exceptional dexterity: Robots have “wrists” and also their instruments can revolve 360 ° within the abdomen, supply a more comprehensive variety of activity than laparoscopic equipment, which has a lobster-like claw grasp. Basically, robot surgical treatment allows for the dexterity of an open procedure making use of just the small cuts of typical laparoscopy.
* Much better ergonomics: The robot enables the doctor to sit at a console with controls within very easy reach. This avoids medical professional arm or leg exhaustion and also uses more exact positioning throughout the one- to three-hour procedure.
* Shorter hospital remains and healing times: This minimally invasive method will often mean less time in the health center, much less discomfort, and also a quicker go back to work for patients.
* Revisional surgery: Robotics can supply additional precision when dealing with attachments or scar tissue from a previous operation.
* Efficiency of complicated treatments: Among the constraints of conventional laparoscopy is the difficulty in performing elaborate or complex treatments. Laparoscopic devices are long and also have a smaller sized series of activity. On the other hand, the robot arms are able to access parts of the abdomen that would certainly run out reach with conventional laparoscopic devices.
* Level of smoothness and Accuracy: The robotic analyzes the cosmetic surgeon’s inputs and also scales them down to make certain perfectly smooth movements. This allows for outstanding accuracy.
* Enhanced control: The doctor manages the robotic arms with both their hands and feet. This allows for using 3 robotic arms while conventional laparoscopy only allows the use of 2 at once. Usually, throughout laparoscopic surgical procedure a surgical aide is required to run one or more of the laparoscopic devices.
* Specialist Comfort: Throughout conventional laparoscopy, the specialist is standing beside the operating room as well as typically searching for at a tv screen. This can be particularly challenging during lengthy surgical treatments or on days when several surgeries are set up. The robot enables the surgeon to sit pleasantly at the console, getting rid of much of that tiredness.
* Viability: Procedures such as the Stomach Bypass are especially suited to robot surgical procedure as this procedure includes a substantial amount of stitching. Improved visualization and better precision means that stitching can be done more safely with the robot.
Dramatically, the ‘wristed’ robotic tools help with stitching with both the dominant as well as the non-dominant hands with equivalent precision making sewing at tough angles, frequently run into in obese patients, more accurate, effective and also much safer. All these features cause further decreasing the risks and also enhancing the result.
– Avoidance of Fatique in Super Morbid Obese Patients: The robot is specific beneficial when operating overweight patients as the significant thickness of the tummy wall can generate exhaustion of the surgeon and therefore boost the threat of errors. Thus it perhaps feasible to execute a gastric bypass on people with a higher BMI (> 60) as opposed to provide them a laparoscopic sleeve gastrectomy.
The robot is likewise much more useful than typical laparoscopy in revisional weight management surgical procedure (conversion from one procedure to one more for eg. Band to Bypass) as an anastomosis that is totally sutured is related to a reduced threat of difficulties than one that is completed with a stapler. With an enhancing demand for these modification treatments, the robotic has a vital role to play in decreasing complications.
* Cosmetic result after a robotic procedure is additionally better than common laparoscopy are the lacerations are smaller and are put much more in the sides instead of the front of the abdomen and are less noticeable.
* The robotic system is ideal for the efficiency of single incision or ‘scarless’ surgery as the robotic tools will certainly deal with several of the current issues with single-incision surgical procedure.
Similar to any kind of new technology, there are additionally a couple of downsides:.
* The learning curve: Many medical professionals graduating from medical college and residency today have not robotic skills in Turkey. Our team did lab simulations, computer system simulations, and afterwards spent hours exercising on wet-labs in international robotic surgery education facilities. All of our robotic surgery team has international certificates.
* Robots do not have real haptics, or touch: Because medical professionals are sitting at a console and taking a look at a screen, they don’t get the tangible sensation of interacting or touching the tissues, but the modern technology is evolving swiftly, as well as I think that will certainly be attended to in the next generation of robots.
* The cost: Surgical robots are pricey- most set you back greater than $1 million- so it is incumbent on the medical area to lower expenses in various other areas, such as shortening healthcare facility stays and recuperation times for patients. Also, some special robotic arms and sleeves ought to be used per patient, which is the main factor of higher costs of robot bariatric surgical procedure.
What are the Risks of Robotic Bariatric Surgery?
As with any surgical treatment, there are risks connected with robot assisted weight-loss surgical treatment. Risks consist of:
* Leak from area where digestive tract was reconnected throughout surgery.
* Leaking from location where bowel was cut.
* Dehydration.
* Nutritional deficiencies.
* Food moves too quickly from tummy into small intestine and can cause Dumping syndrome.
Recovery from Robotic Bariatric Surgery
Most individuals who have robotic bariatric surgical procedure can expect a two- to three-week recovery period after surgery. Resting is important during the recovery period to allow your body to heal.
It is also essential to follow your physician’s directions on the amount of calories you must be consuming throughout this period. You should not work out during the recovery period.
Work together with our bariatric specialist and also weight reduction team to develop a plan to progressively start an exercise program.
Keys to Long-term Success of Robotic Bariatric Surgery
It is essential to commit yourself to a healthier way of living after any kind of weightloss surgery. Keys to success after robotic weight loss surgery procedure include:
* Eat 3 well balanced meals every day – prevent snacking.
* Consume plenty of water throughout the day.
* Eat healthy protein with every dish, ideally very first – you will certainly eat much less food if you consume healthy protein initially.
* Exercise regularly.
Conclusion
Robotic bariatric surgery stays a valid medical method in dealing with morbid obesity, but, due to its higher prices, it can not be a first-choice choice as its advantages over laparoscopy are limited to bariatric surgeon ergonomics as well as not to client perioperative care and also, as a result, it is not financially lasting. However, in chosen situations, consisting of revisional cases and also superobese patients, robotic surgical procedure could have a potential function in minimizing postoperative issues and boosting perioperative treatment, as well as, for that reason, it also could be financially sustainable.