Totally Robotic Stapleless Vertical Sleeve Gastrectomy

Masoud Rezvani, MD, Iswanto Sucandy, MD, Gintaras Antanavicius, MD

Abington Memorial Hospital

Introduction: Bariatric surgery has been reported to be the most effective and durable treatment for morbid obesity and its associated medical comorbidities. Currently, several minimally invasive procedures are available which include vertical sleeve gastrectomy (VSG). During VSG, sequential firing of linear stapler creates a longitudinal gastric sleeve along lesser curveture. We report an alternative approach of totally robotic stapleless VSG and hand sewing gastrostomy in a patient with questionable staple component allergy which prevented us using linear staplers.

Surgical technique: A 45 year-old-man with BMI of 44 kg/m2 presented for treatment of morbid obesity. Past medical history was significant for multiple comorbidities including diabetes, hypercholesteronimia, and depression. In addition, he had a questionable allergy to staple component. During elective totally robotic stapleless VSG, 36-French size bougie was used to create the gastric sleeve. Gastric transection and over sewing in two layers by using 3-0 vicryl and 2-0 prolene along longitudinal axis was performed with robot arms. The operation had minimal blood loss (<50ml). There were no intraoperative or immediate postoperative complications. The patient made an uneventful recovery and was discharged home on postoperative day 3. In 1 week follow-up, he was seen in our bariatric office in a good health and returned to his usual daily activities.

Conclusions: A totally robotic approach is safe and technically feasible in VSG. The robotic stapleless approach serves as an alternative to the standard laparoscopic VSG, and can be considered when linear staplers cannot be utilized safely.

Session: Video ChannelDay 2

Program Number: V067

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