|
About Robotic Roux-en-Y Gastric Bypass
The Roux-en-Y gastric bypass is considered by many to be the most effective surgical treatment for significant, permanent weight loss. In this procedure, the surgeon creates a small stomach pouch and then constructs a "bypass" for food. The bypass allows food to skip parts of the small intestine. By skipping a large part of the small intestine, the body cannot absorb as many calories or nutrients.
The Roux-en-Y has been performed for over 20 years as both an open and laparoscopic surgical procedure. The McLaren Bariatric and Metabolic Institute has taken the lead in offering the most advanced form of surgery with the da Vinci Surgical System, a tool which uses robotic technology to assist surgeons and benefit patients.
The differences between laparoscopic and robotic surgery is in the range of motion, visibility, and complexity.
Robotic-assisted surgery provides surgeons with an alternative to both traditional open surgery and conventional laparoscopy, putting a surgeon’s hands at the controls of a state-of-the-art robotic platform. The da Vinci System enables surgeons to perform even the most complex and delicate procedures through very small incisions with unmatched precision.
"Certain surgical procedures requiring a greater range of motion can now be performed through the minimally invasive techniques," Dr. Kia said. "This benefits patients as well as the surgeon."
In addition to the greater range of motion, the robotic-assisted surgical system provides 3-D visualization technology for a superior picture of the surgical site.
What does this mean for you, the patient?
Minimally invasive gastric bypass compared to an open surgical procedure may result in:
Michael Kia, D.O., a member of the medical staff at McLaren, is the only fellowship trained robotic general surgeon in Michigan and the only laparoscopic trained surgeon in Genesee County.
"The da Vinci System is simply an extension of the surgeon’s own hands," said Dr. Kia. "Robotic-assisted technology will eventually replace laparoscopic surgical techniques as the next generation of surgery. We are fortunate to be one of the first locations in Michigan to benefit from this great advance."
Advantages and Disadvantages of the Roux-en-Y surgical procedure
Advantages
A 2004 meta-analysis of more than 22,000 patients showed that those who underwent a bariatric surgical procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.
- 83.7 percent of type 2 diabetes cases were resolved.
- In the studies analyzed, the control group that didn’t have bariatric surgery was at a higher risk for type 2 diabetes: 3.7 times higher.
- Resolution of type 2 diabetes often occurred within days of the surgery.
- 96.9 percent of hyperlipidemia cases were resolved.
- 75.4 percent of hypertension cases were resolved; 87.1 percent were resolved or improved.
- Substantial weight reduction occurred; 61.6 percent of excess weight was lost.
- In 2000, a study of 500 patients showed that 96 percent of co-morbidities (the study looked specifically at back pain, sleep apnea, high blood pressure, type 2 diabetes, and depression) were improved or resolved.
- A great deal of excess weight was lost, and patients experienced resolution of co-morbidities, and improved appearance, social opportunities, and economic opportunities.
Risks and Disadvantages
McLaren-Flint continues to be on the leading edge of technological advancements in the field of medicine. The introduction of robotic surgery exemplifies McLaren’s commitment to advancing patient care and advancing healthcare in the community.
Because the duodenum and other sections of the small intestine are bypassed, poor absorption of iron and calcium can cause low total body iron and a greater chance of having iron-deficiency anemia. Patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids should be aware of the chance of iron-deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the possibility of increased bone calcium loss. By taking a multivitamin and calcium supplements, patients can maintain a healthy level of minerals and vitamins.
Bypassing the duodenum can cause metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hipbones. Eating foods rich in nutrients and taking vitamins can help patients avoid this.
Chronic anemia due to vitamin B12 deficiency may occur. The problem usually can be managed with vitamin B12 pills or injections.
A condition known as dumping syndrome can occur from eating too much sugar or large amounts of food. While it isn’t considered a serious health risk, the results can be very unpleasant. Symptoms can include vomiting, nausea, weakness, sweating, faintness, and, on occasion, diarrhea. Some patients are unable to eat sugary foods after surgery.
The bypassed portion of the stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are problems such as ulcers, bleeding, or malignancy.
The procedure could result in death.
|
Michael Kia. M.D.
Listen to Dr. Kia's radio spot on bariatric surgery.
Harris Dabideen. M.D.
|