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Obesity Surgery

, Volume 13, Issue 6, pp 848–854 | Cite as

DaVinci® Robotic-Assisted Laparoscopic Bariatric Surgery: Is it Justified in a Routine Setting?

  • Gilbert Mühlmann
  • Alexander Klaus
  • Werner Kirchmayr
  • Heinz Wykypiel
  • Andreas Unger
  • Elisabeth Höller
  • Hermann Nehoda
  • Franz Aigner
  • Helmut G Weiss
Article

Background: Laparoscopic silicone adjustable gastric banding (SAGB) has gained popularity for the surgical treatment of morbid obesity. The implantable gastric stimulator (IGS®) system represents a novel surgical alternative. We aimed to assess the feasibility of robotic-assisted laparoscopic bariatric operations and to critically elucidate the technical and financial advantages and patient outcome. Methods: Robotic-assisted laparoscopic bariatric procedures were performed on 10 consecutive patients using the daVinci® robot system (4 SAGB, 4 IGS®, 2 SAGB revisions). 10 conventional laparoscopic-operated patients (4 SAGB, 4 IGS®, 2 SAGB revisions) during the learning curve served as controls. Equipment, operative technique and procedural time were evaluated. A cost analysis was calculated. Results: The personnel equipment, numbers of trocars and operation technique were comparable in both groups. The mean operative time was 137 min (range 110-175) and 97 min (60-140) in robotic-assisted and conventional laparoscopy, respectively (P =0.04). Establishment of the pneumoperitoneum and placement of trocars and robotic arms took a mean of 30 min (15-45) in the robotic-assisted group, compared with 5 min in the control group (P <0.001). In 1 patient, intraoperative gastric injury was suspected and led to band removal in the robotic-assisted group. There was no postoperative complication. Average procedural costs were significantly higher in the robotic-assisted group. Conclusion: Primary and revisional robotic-assisted bariatric surgery is technically simple, with the benefit of precise instrument handling. However, it is still expensive, the set-up of the system is time-consuming, and a limited variety of instruments are available presently.

MORBID OBESITY BARIATRIC SURGERY LAPAROSCOPY ROBOTIC 

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Copyright information

© Springer 2003

Authors and Affiliations

  • Gilbert Mühlmann
    • Alexander Klaus
      • Werner Kirchmayr
        • Heinz Wykypiel
          • Andreas Unger
            • Elisabeth Höller
              • Hermann Nehoda
                • Franz Aigner
                  • Helmut G Weiss

                    There are no affiliations available

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