The obesity phenomenon is growing and has become a significant public health problem. Turkey is among the first European countries in terms of the prevalence of obesity, with 40% of women and 20% of men affected by this condition. With high success rates, surgical treatment of obesity and metabolic problems has gained importance and is used primarily to treat obesity-related diseases such as diabetes and high blood pressure. Gastric bypass is considered the gold standard in this type of surgery.
The frequent use of laparoscopic (keyhole) surgical techniques has greatly made life easier for both doctors and patients. However, these techniques have their limitations; the devices have limited mobility and capacity for two-dimensional imaging. For these reasons, robotic surgery is being developed to address these limitations. This system uses highly mobile robotic arms that are remotely controlled instead of manually operated devices directly by the physician. These robotic arms are capable of mimicking the actions of a human wrist, but with the capabilities of much greater precision and mobility.
Three-Dimensional Imaging
In addition to providing clearer images, the robotic surgery system provides the surgeon with image depth and a sense of depth in movement, using three-dimensional images from the field of surgery. As the camera is under the surgeon's control, it also allows him to more easily operate in confined and tight spaces that are inaccessible to conventional keyhole-type equipment. This serves to minimize injury from the surgery.
High Mobility
As with the human wrist, the devices on the end of the robotic arm have the ability to rotate 180 degrees in any direction. This facilitates access and the surgeon's ability to work in confined or inaccessible areas, giving them greater freedom of movement and greatly facilitating suturing. The sensitivity of the robotic arm eliminates the problems associated with normal human hand tremors.
Greater Comfort for the Surgeon
The doctor remains seated in the console during robotic surgeries; the surgery is performed using three-dimensional imaging. This reduces the stress and fatigue he/she feels and prolongs the duration and strength of his concentration.
What are the benefits of robotic surgery for the patient?
Robotic surgery is performed with very small surgical incisions and with far better aesthetic results. In addition, side effects such as hemorrhage or leakage that can prolong a patient's hospital stay are also reduced.
DaVinci® Robotic Surgical System
The Da Vinci Robotic System is increasingly used in cases of obesity surgery.
- Console: this is where the surgeon sits, where the three-dimensional images are obtained and from where the robotic device and arms are controlled.
- Control tower: the monitor, light sources and robotic arms are attached to this part of the device.
- Patient side: in this part are the 4 robotic arms: one for the camera and the other 3 for the control of the Da Vinci devices.
Robotic surgery techniques are particularly applicable to obesity surgeries, which pose a challenge even for laparoscopic techniques and cases where possible side effects could be life-threatening. Robotic surgery provides tremendous benefits to both the patient and the surgeon, especially for operations such as bypass surgery that require a very high level of skill and experience.
Benefits:
- Surgery is performed using three-dimensional imaging
- Patients with a high body mass index are treated more easily and comfortably with a single operation
- More precise control and facilitation for the surgeon so their skills can be used more comprehensively
- Easier and more precise suturing
- Greater precision and quality in the incision
- Better ergonomic capabilities that reduce surgeon fatigue
- Reduced chance of post-operative complications such as bleeding or leakage
- Earlier return of the patient to daily activities
- Shorter hospital stay
The Gold Standard in Obesity Surgery: Gastric Bypass Surgery
Gastric bypass surgery has been performed in the United States for the past 30 years. In the beginning, these surgeries were performed with an open operation; over time, keyhole-type techniques became more widespread. In modern times, the era of robotic surgery has begun, with higher success rates and efficiency.
With its long-term results and success rates, robotic surgery is considered the gold standard in obesity surgery. Its contribution to weight loss is greater than other techniques. With this technique, patients lose 80% of their excess weight and continue to lose weight for a period of 18-24 months. This method, also, enjoys a higher success rate compared to conventional methods in terms of effectiveness in treating obesity-related diseases such as diabetes, high blood pressure and lipid disorders (cholesterol, etc.).
Nutritional intake and patient absorption levels are effectively reduced.
Unlike other surgeries, the improvement of type-2 diabetic conditions begins not with weight loss, but at a much earlier stage, even before weight loss has begun. 80% of diabetic patients experience overall improvement and 10% experience partial improvement.
Advantages of Robotic Surgery
- Fewer complications/side effects
- Less chance of surgical wound infection
- Less likelihood of needing to switch to open surgery
- Shorter hospital stay
- Advantages of robotic gastric bypass surgery
- Lower chance of prolapse
- Lower rate of re-operations
- Less likelihood of needing to switch to open surgery
- Less fatigue and better opportunity for surgeon concentration.