Bariatric surgery has traditionally been done by the laparoscopic approach since the last two decades. In fact, the many advantages of laparoscopy including the minimally invasive technique, increased precision, less blood loss and faster recovery have popularised bariatric surgery amongst the patient population.
Now, with technological advancements, robotic surgery is here to challenge the dominant place occupied by laparoscopic surgery in the field of Bariatrics.
Robotic surgery offers all the advantages offered by laparoscopy to the patient with many more benefits. It is an enabling technology and the correct term for it would be a robot assisted surgery since in fact the surgery is performed by the surgeon who is controlling the movements of the robotic platform.
This interface actually provides a much superior and comfortable platform for the surgeon to perform the procedure. It offers an excellent three dimensional visualisation and eliminates the restriction of freedom of movements in traditional laparoscopy. The robotic instruments have movements with up to eight degrees of freedom similar to the human wrist which is particularly useful in complex tasks like endosuturing. This also becomes relevant in cases of difficult anatomy like super obesity, dense adhesions and revisional procedures and provides an ease over and above traditional laparoscopy.
The robotic interface fine tunes the movements and eliminates tremor which can be challenge for aged surgeons. Moreover, the camera control is with the surgeon so it eliminates the need for an additional camera assistant. Most robotic systems have 3-4 arms which means that additional retraction during the procedure is also possible without an assistant surgeon.
All these technological advancements however come with a cost. The current robotic systems require huge investments not only fit purchase of the equipment but also in terms of its operations and maintenance. The cost to the patient is often daunting and most people opt out of the procedure in a self-pay scenario. However, new companies are coming up with their own robotic systems which is making the market competitive with a promise to make this technology more affordable in the future.
Thus, laparoscopic and robotic bariatric surgeries are both effective tools for tackling the modern epidemic of obesity. While laparoscopy is the dominant approach in the current scenario, robotic surgery promises to replace it in the near future.