Laparoscopic vs. Robotic surgery?

[BariatricMD 0]

Bariatric surgeon here! Looking to gain insight into patient perspectives on surgery. If you could choose how your bariatric operation was going to be performed, what technique would you request? Please leave any additional comments as well. Thank you for your insights!

[liveaboard15 1,293]

My reasoning on not using robotic is because the surgeon is not right there, They are not scrubbed in and (Correct me if i am wrong) if something does go wrong and he needs to do something beyond the capabilities of the robot they would need to get scrubbed in which takes time. Also and correct me if i am wrong, Robotic surgery would probably cost a lot more and with bariatric surgery many of us including myself are self pay.

[BariatricMD 0]

16 minutes ago, liveaboard15 said:

My reasoning on not using robotic is because the surgeon is not right there, They are not scrubbed in and (Correct me if i am wrong) if something does go wrong and he needs to do something beyond the capabilities of the robot they would need to get scrubbed in which takes time. Also and correct me if i am wrong, Robotic surgery would probably cost a lot more and with bariatric surgery many of us including myself are self pay.

Realizing now that responding to comments may sway the opinions of those who haven't responded yet. Thanks for your input--I will provide a response after more votes come in!

[catwoman7 11,212]

34 minutes ago, liveaboard15 said:

My reasoning on not using robotic is because the surgeon is not right there, They are not scrubbed in and (Correct me if i am wrong) if something does go wrong and he needs to do something beyond the capabilities of the robot they would need to get scrubbed in which takes time. Also and correct me if i am wrong, Robotic surgery would probably cost a lot more and with bariatric surgery many of us including myself are self pay.

I would assume there would always be a surgeon at the ready in case anything went wrong, so that wouldn't really concern me. That said, I think I'd prefer just the regular laparoscopic (which I had)

[BariatricMD 0]

4 minutes ago, catwoman7 said:

I would assume there would always be a surgeon at the ready in case anything went wrong, so that wouldn't really concern me. That said, I think I'd prefer just the regular laparoscopic (which I had)

Thanks for your reply! Any specific reason why laparoscopic seems more appealing? Thank you again for participating.

[BigSue 1,373]

My surgeon used the Da Vinci robotic system. He was oddly emphatic that HE (the surgeon) would be performing the surgery with the robot; I guess some people have a misconception that robotic surgery means that a robot is performing the surgery.

Given the choice, I would prefer robotic surgery. My surgeon said that he performs the surgery both with and without the robot, but he prefers the robot, and frankly, that is reason enough for me. Surgery requires a high level of skill and attention to detail, and I want my surgeon to use the tools with which he is most comfortable and that allow him to do his best work. I was also told that robotic surgery can allow the surgeon to make smaller incisions, so that's a bonus.

[BariatricMD 0]

8 minutes ago, BigSue said:

My surgeon used the Da Vinci robotic system. He was oddly emphatic that HE (the surgeon) would be performing the surgery with the robot; I guess some people have a misconception that robotic surgery means that a robot is performing the surgery.

Given the choice, I would prefer robotic surgery. My surgeon said that he performs the surgery both with and without the robot, but he prefers the robot, and frankly, that is reason enough for me. Surgery requires a high level of skill and attention to detail, and I want my surgeon to use the tools with which he is most comfortable and that allow him to do his best work. I was also told that robotic surgery can allow the surgeon to make smaller incisions, so that's a bonus.

Thanks for the helpful response! Will reply with more details later to avoid influencing opinion.

[RickM 1,747]

Under the premise that the most important component of your car is the nut holding the steering wheel, I don't have a real preference; it's a tool and the most important part is still what's between the surgeon's ears.

The doc who adopted our local support group, one who is well regarded for doing complex revisions, has mentioned that he has no real preference to them - he uses them if the hospital he is at has it and it is available, but he isn't specifically scheduling himself around it.

My real concern is would the robot help a surgeon who is low on the learning curve, say on doing sleeves, be less likely to make a sleeve with a stricture? Or if the surgeon is one who is apprehensive about working around a fatty liver be less likely to close up and send the patient home without completing the job?

[ShoppGirl 4,790]

I admit I don’t know a ton about it but I think I would go with robotic because robots are so precise. I had very little pain post op and i told the NP that I like to think that was because I did so good on the liver shrink diet and she said she is sure it was part of it that my liver was small and out of the way. Well if that is true then I’m guessing a robot could manipulate things around with even less bumping and bruising meaning less pain (I assume). This is also assuming that a doctor is right there ready to go if something goes wrong.

[BariatricMD 0]

On 4/3/2022 at 11:03 AM, RickM said:

Under the premise that the most important component of your car is the nut holding the steering wheel, I don't have a real preference; it's a tool and the most important part is still what's between the surgeon's ears.

The doc who adopted our local support group, one who is well regarded for doing complex revisions, has mentioned that he has no real preference to them - he uses them if the hospital he is at has it and it is available, but he isn't specifically scheduling himself around it.

My real concern is would the robot help a surgeon who is low on the learning curve, say on doing sleeves, be less likely to make a sleeve with a stricture? Or if the surgeon is one who is apprehensive about working around a fatty liver be less likely to close up and send the patient home without completing the job?

Very thoughtful answer--thanks for your input! More detailed reply to come. Hoping others will participate in the meantime.

[BariatricMD 0]

19 hours ago, ShoppGirl said:

I admit I don’t know a ton about it but I think I would go with robotic because robots are so precise. I had very little pain post op and i told the NP that I like to think that was because I did so good on the liver shrink diet and she said she is sure it was part of it that my liver was small and out of the way. Well if that is true then I’m guessing a robot could manipulate things around with even less bumping and bruising meaning less pain (I assume). This is also assuming that a doctor is right there ready to go if something goes wrong.

Thanks so much for your thoughts on this. Will see if other patients are willing to chime in. Thanks again!

[ardelia 41]

My surgeon did robotic surgery for my RNY. I was disappointed that I didn't get to "meet" the robot. My surgeon does surgery with and without the robot. As long as the surgeon is comfortable using the robot, then I am fine with it. A simple Google search brings up risks and benefits of robot-assisted surgery and having read these (shorter hospital stay, smaller incisions, less chance of infection, etc.), I can't really see why people would prefer regular laparoscopic surgery.

[mrsjo 69]

I’m up for whatever my surgeon has the most proficiency in. They are the experts. If they have done more one way or the other or have better skill (not as if they would say that) with one way or the other I would be most comfortable with that. My surgeon does all other surgeries robotically, however the RNY and sleeve he does laparoscopically. He says they’ve fine tuned it down to a very short operating time and having no issues and at this point aren’t switching that because he says “anytime you start changing technique you always have some issues”. Sounds like he isn’t willing to risk the “test patients”. It wasn’t a deal breaker for me and the previous surgeon I switched from decides on the last preop appointment which one she will do. I never found out what made her lean one way or the other. I’m guessing it has to do with size?

[Possum220 230]

I just cant seem to come at the idea of a robot doing surgery on me. I will be having an RNY. Dont surgeons need to feel/look inside a body in order to do a good job. Maybe it is all too new fangled or I am too old? 😁

[Capri81 21]

As a RN my perspective is a little different. I want whatever method my surgeon feels is best for the true variable:me. Each patient has their own complexities and surgeons are trained to deal with them. I’ve been a nurse long enough I have seen some procedures switch from open to lap to robot. Surgeons that utilize robotic assistance still need to be trained in other methods. My cardiologist told me to go with the surgeon I feel comfort and trust in and to me that means the one that will see me as a person and not a number to just perform a surgery on. That would include trust in which method is best and reduces risk for me.