Evolution of Technology

Robotic Bariatric Surgery

Robotic Surgery was first introduced in 1985 when a robotic surgical arm was used in a neurosurgical biopsy. Shortly thereafter, in 1987, the first robotic gallbladder surgery was performed. Over the next three years, the robot’s umbrella expanded to include other operations and with different competing robotic systems.

In 1990 the FDA approved the first robotic endoscopic procedure, and in 2000 the first robot was FDA approved for laparoscopic surgery. Since its expansion, the robot has changed with regard to the number of arms, precisions of arm movements, docking ability, and picture quality including three dimensional screens.

In terms of bariatric surgery, the robot was first used in 1998 to place a gastric band. Since the advent, its use has expanded to all forms of bariatric surgery including sleeve gastrectomy, gastric bypass, and duodenal switches. Studies have even demonstrated efficacy of robotic revisions bariatric surgery. Robotic assisted bariatric surgery is performed under general anesthesia and usually requires overnight observation in the hospital with discharge the follow day.

Evolution of Procedure

Bariatric Surgery

Bariatric surgery is the result of approximately 50 years of improvement in surgical practice. The first bariatric operation was a jejunoileal bypass performed in 1956, but due to severe comorbidities such as dehydration and malabsorption, this practice was abandoned for the gastric bypass (gastroplasty w/ loop gastro-jejunostomy) procedure in 1960’s by Edward Mason.

The exact mechanism of bypassing the stomach was changed multiple times over the course of the late 20th century, but the concept of bypassing the stomach has held true and is one of the accepted standards today for bypass surgery.

Most surgeons today perform a variation of a Roux-En-Y bypass which consist of a gastoplasty (reduction of stomach size) and a gastrojejunostomy (connection of the newer smaller stomach to small intestine further down the digestive tract). Other procedures commonly performed include gastric sleeve, gastric band (both reduce the overall active stomach size), and gastric stimulators.