title: Initial experience with robotic sleeve gastrectomy for morbid obesity.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is used with increasing frequency for the treatment of morbid obesity. The application of robotic techniques has been reported for bariatric operations like laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding, but not for LSG. We report herein our initial experience with LSG performed with the use of the Da Vinci surgical system.
  
  
  METHODS
  Nineteen consecutive patients underwent LSG with the use of the Da Vinci surgical system by the same surgical team. Surgical techniques followed the principles of standard LSG. Preparation of the stomach was performed by the console surgeon and its division with the staplers by the patient-side surgeon.
  
  
  RESULTS
  Seventeen women and two men with a mean age of 39.4 years and a mean body mass index (BMI) of 48.2 kg/m(2) were operated. Mean operative time was 95.5 ± 11.5 min. Docking time was 16 ± 4.2 min. There were no conversions. Peri-operative morbidity and mortality was zero. Time to BMI ratio for robotic LSG was 2 ± 0.3 min/kg/m(2) and it was equal to the respective of our standard LSGs. When the docking time was excluded, the same ratio was 1.7 ± 0.2, significantly shorter than the respective 2.0 ± 0.5 of our conventional LSGs (p = 0.018). Mean excess body weight loss 1 year post-operatively was 65.5 ± 25.6%.
  
  
  CONCLUSIONS
  Robotic laparoscopic sleeve gastrectomy is a feasible, safe, and efficient surgical technique for the treatment of morbid obesity and it does not add to the operating time of the procedure.
authors.affiliation: Laiko Athens General Hospital, 1st Department of Surgery, University of Athens, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Diamantis
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Nikiteas
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Eustathios
authors.initials: E
authors.lastname: Papalambros
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss