Bariatric and revisional robotic surgery

The use of robots to assist in performing surgical tasks has been developed over the last decade. Robotic digital platforms provide potential benefits such as three-dimensional visualization, wristed instruments which lead to enhanced dexterity, and blocking the transmission of torque on ports. These advantages become remarkable when the robot system is employed in bariatric surgery. This review explores the literature and examines the surgical outcomes and complications in robot bariatric surgeries. Robotic adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), biliopancreatic diversion (BPD) with duodenal switch (BPDDS), and revisional bariatric surgery (RBS) are assessed. The review showed that robot bariatric surgeries generally led to comparable or better outcomes and shorter learning curve than conventional laparoscopic surgeries. However, most upper gastrointestinal (UGI) and bariatric surgeons in East Asia are commonly exposed to laparoscopic gastrectomy because of high incidence of gastric cancer in this area and they are already well-trained laparoscopic surgeons. Therefore, most of them still prefer laparoscopic techniques because it has proven clinical benefits, does not require complex setups, and super obese patients are not as common as Western countries. More research is needed to elucidate accurate conclusion in East Asia.