Laparoscopy / Robotic Surgery
Most gastrointestinal surgeries including weight loss surgeries today are performed using Laparoscopy and more recently Robotically as they significantly improve the safety and outcome. The choice of technique is chosen based on factors like surgeon's expertise, complexity of procedure, previous surgery, body composition, etc.
Conventional Laparoscopic Surgery
Laparoscopic surgery or Keyhole surgery is a modern surgical technique in which, operation in the abdomen is performed through small incisions (usually 0.5 – 1.3 cm) as opposed to the larger incisions in open surgery. The surgeon operates through long instruments passed through these holes visualising the internal space through a telescopic camera. There are numerous advantages to the patient which include, fewer errors due to magnification, reduced pain due to lesser insult, minimal or no bleeding and shorter recovery time
Single Incision Laparoscopic (SILS)
SILS is the next generation of Laparoscopy, wherein the access is only through a single port through the belly button instead of multiple ports. This utilizes new specialized port and roticulator instruments along with specialised cameras. This makes the procedure literally scarless as it will be buried inside the belly button. This procedure though consumes more time, gives early postoperative recovery with less pain than in conventional laparoscopy, especially in weight loss surgery; thus, making it a treatment of choice for patients. However, it requires expert skills and is not suitable for all patients.
Robotic Surgery
Robot-assisted surgery, the latest major evolution in minimal access surgery is considered for complex Bariatric procedures. The surgeon performs the movements associated with Laparoscopy on a robotic console through a joystick whilst the robotic arm on a remote cart carry out the actual surgery on the patient. Some major advantage of robotics are three-dimensional magnification, precision, less pain, decreased blood loss, and quicker healing time; thus, improving the outcome and safety.
Endoscopic Surgery
Endoscopic surgery is the latest kid on the block which provides a unique alternative and also is an effective therapy for weight loss without the risk of surgery. The procedures is performed through specialised endoscope, suturing and clipping devices. As weight loss is only moderate, it is indicated in a few select candidates or as a first stage procedure for a super obese. It is an effective alternative for revision procedures for weight regain after initial period of weight loss.
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