Technical considerations for robotic gastric bypass: comparing traditional and omega loop techniques

Abstract

Robotic surgery has become ubiquitous across a variety of surgical specialties including bariatric surgery. Application of this new technology to bariatric surgery requires some modifications to the traditional laparoscopic technique to accomplish the procedures effectively and efficiently. In this technical report, we describe our approach to robotic Roux-en-Y gastric bypass, outline potential benefits over laparoscopy, and highlight technical variations in the conduct of this operation that may be helpful to practicing bariatric surgeons, especially those who plan to adopt robotic surgery to their practice. We present handsewn vs. stapled gastrojejunostomy creation, omega loop technique vs. traditional construction of the jejunojejunostomy, and other technical variations. Each method has its own advantages and disadvantages which we have highlighted throughout this article. We also discuss pre- and postoperative management. When compared to traditional laparoscopic gastric bypass, robotic approaches remain less often used in current practice but are expected to surpass laparoscopy in just a few years. A robotic approach offers unique benefits for gastric bypass while still proving to be a safe and effective procedure for surgical weight loss.

Keywords

Robotic surgery / bariatric surgery / Roux-en-Y gastric bypass / omega loop

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