This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

Obesity has become a major global health concern, leading to numerous chronic conditions such as diabetes, hypertension, sleep apnea, and cardiovascular diseases. For patients struggling with severe obesity, surgical interventions offer the most effective long-term solution. Among these, Robotic Sleeve Gastrectomy (RSG) has emerged as a cutting-edge minimally invasive procedure, combining the effectiveness of traditional bariatric surgery with the precision and advantages of robotic technology.

What is Robotic Sleeve Gastrectomy?

Robotic Sleeve Gastrectomy is a type of bariatric surgery where a significant portion of the stomach (around 75–80%) is removed, leaving a narrow, sleeve-shaped stomach. This procedure reduces the stomach’s capacity, limiting food intake, and also impacts hunger hormones, aiding in significant and sustained weight loss.

Unlike traditional laparoscopic sleeve gastrectomy, robotic surgery utilizes a robotic system controlled by a skilled surgeon, offering enhanced precision, better visualization, and improved ergonomics.

Advantages of Robotic Sleeve Gastrectomy

1. Enhanced Precision: The robotic system allows surgeons to make highly accurate movements, reducing the risk of complications.

2. 3D Visualization: High-definition, 3D imaging provides a clearer view of the surgical area, improving safety and outcomes.

3. Minimally Invasive: Smaller incisions mean less pain, minimal scarring, and faster recovery compared to open surgery.

4. Reduced Risk of Complications: The robotic approach allows precise suturing and dissection, lowering the risk of bleeding and leaks.

5. Shorter Hospital Stay: Most patients can return home within 2–3 days after surgery.

6. Faster Recovery: Patients often resume normal activities sooner due to reduced trauma and pain.

The Procedure Step by Step

1. Anesthesia: The patient is placed under general anesthesia.

2. Port Placement: Small incisions are made in the abdomen to insert robotic instruments and a camera.

3. Stomach Dissection: The surgeon carefully separates the stomach from surrounding tissues using robotic arms.

4. Sleeve Formation: Approximately 75–80% of the stomach is removed using a stapling device, leaving a tube-like structure.

5. Staple Line Reinforcement: The stapled edge may be reinforced to reduce the risk of leaks.

6. Completion: The removed portion of the stomach is extracted, and instruments are removed. The incisions are closed and dressed.

Recovery and Postoperative Care

• Patients typically spend 2–3 days in the hospital.

• A liquid diet is followed for the first few weeks, gradually progressing to soft foods and then a regular diet.

• Regular follow-ups are essential to monitor weight loss, nutrition, and overall health.

• Exercise and lifestyle modifications are crucial for long-term success.

Who is a Candidate?
Robotic Sleeve Gastrectomy is recommended for patients with:

• Body Mass Index (BMI) ≥ 40, or ≥ 35 with obesity-related health conditions

• Failure of non-surgical weight loss methods

• Commitment to long-term lifestyle changes

Conclusion
Robotic Sleeve Gastrectomy represents a significant advancement in bariatric surgery, offering a safer, more precise, and patient-friendly approach to weight loss. With improved outcomes, reduced complications, and faster recovery, it is becoming a preferred choice for patients seeking effective and minimally invasive solutions for obesity.