May 20th, 2012 19:56 EST
First Robotic Bariatric Surgery Performed at St. Luke`s University Hospital-Bethlehem
St. Luke`s bariatric surgeon Leonardo Claros, MD, FACS, FASMBS, Section Chief and Medical Director, St. Luke`s Bariatric Surgery Program, St. Luke`s University Health Network, has performed the first robotic bariatric Roux-en-Y gastric bypass procedure using the daVinciÂ® Si Surgical System at St. Luke`s University Hospital on, May 16, 2012. Assisting him was the St. Luke`s Bariatric Surgery Program`s Co-medical Director and bariatric surgeon Maher El Chaar, MD, FASMBS. Dr. Claros and El Chaar are both fellowship trained in bariatric surgery and have performed more than 1400 laparoscopic bariatric surgeries combined.
The daVinciÂ® Si HD Surgical System integrates 3-D high definition (HD) endoscopy and state-of-the-art robotic technology to virtually extend the surgeon`s eyes and hands into the surgical field. Dr. Claros was formally trained to perform robotically-assisted bariatric procedures while inBoston three years ago and has already performed the operations there, although this will be the first time such a novel approach is used in the Lehigh Valley.
The robotic platform offers many advantages when compared to a traditional laparoscopic approach including better optics and visualization, greater precision on tissue dissection and superior surgical ergonomics, according to Dr. Claros. "Even though many of the potential benefits have not been scientifically demonstrated yet due to the lack of data, robotic surgery is clearly the future and will be what laparoscopy was at the end of the 1980s," says the surgeon. "An increasing number of hospitals are adopting this technique across multiple specialties. With the new Si robot, the surgical instrument reach for bariatric cases has been optimized making these cases easier to perform when compared to previous models."
Surgical weight loss is often the only way for most people suffering from clinically severe obesity to lose weight for the long term. Bariatric surgery can lead to a healthier weight, decrease the likelihood of developing certain illnesses and improve quality of life. Health concerns associated with obesity include type 2 diabetes, high blood pressure, stroke, heartburn, sleep problems, hernia, fatty deposits in the blood, osteoarthritis and certain cancers. For people who suffer from an obesity-related condition, bariatric surgery can improve and even reverse these conditions.
Drs. Claros and El Chaar also perform the traditional laparoscopic Roux-En-Y gastric bypass, the laparoscopic adjustable gastric band and the laparoscopic sleeve gastrectomy as well as the single incision laparoscopic bariatric surgery and the Natural Orifice Translumenal Endoscopic Surgery (NOTES) at St. Luke`s Hospital-Allentown Campus.
St. Luke`s first robotic bariatric surgery patient
Michelle Star, 54, of Stroudsburg was the first patient to undergo the robotic bariatric surgery at St. Luke`s University Hospital. Star weighs 216 pounds and has had a weight issue since childhood. She has been on medications for high blood pressure and cholesterol and hopes to reduce or eliminate the need for these medications once she reaches a healthy weight.
"As Michelle reaches her normal weight, there`s a great chance she will no longer need these medications to maintain good health," says Dr. Claros. "She should start experiencing significant weight loss the first week and, if she complies with the program after surgery, is expected to achieve or get close to her goal weight of 145 pounds within a year."
The surgery itself is not a silver bullet, explains Dr. El Chaar. "Patients must also realize they are undergoing a lifestyle change after surgery and will need to follow certain rules to stay healthy and be successful," he says. "We have a support team of experienced bariatric professionals at St. Luke`s to help patients every step of the way, from nurses and registered dietitians to psychosocial specialists and a lifestyle specialist."
Who qualifies for weight loss surgery?
Weight loss procedures are for patients who are extremely, or morbidly obese. To qualify for weight loss surgery, individuals must be 100 pounds or more overweight and have a body mass index, or BMI, greater than 40 or have a BMI of 35 to 39.99 accompanied by an obesity-related medical condition like diabetes, high blood pressure or sleep apnea. At St. Luke`s the laparoscopic sleeve gastrectomy is available to adults with a BMI between 35 and 55. Obese patients who have serious health issues such as diabetes may also be considered for weight loss surgery to improve overall health and well-being.
St. Luke`s bariatric surgery results receiving national attention
St. Luke`s exceptional results in performing bariatric surgery on "super obese" patients "those patients with extremely high BMIs of 50 and above "are receiving national attention. Dr. El Chaar will present on St. Luke`s bariatric surgery results for super obese patients at the 29th annual American Society of Metabolic and Bariatric Surgery meeting in San Diego, California June 17-22, 2012.
"Traditionally, patients who are super obese are turned down for surgery at many hospitals and bariatric centers across the country since they are considered to be too high risk and have more complications following surgery," says Dr. El Chaar. "Statistics have shown that St. Luke`s super obese patients do just as well during and after surgery as the typical clinically obese candidate for bariatric surgery."
Laparoscopic bariatric procedures performed at St. Luke`s Hospital-Allentown Campus
The Laparoscopic Roux-En-Y. During the Roux-En-Y gastric bypass, a small pouch is formed from the top part of the stomach and a portion of the small intestine is bypassed. Weight loss is achieved by restricting the amount of food one can eat and through decreased absorption of calories. Weight loss is usually rapid with most of the weight lost in the first year. The procedure is performed through tiny incisions made in the abdomen.
The Laparoscopic Sleeve Gastectomy. This restrictive procedure causes weight loss by reducing the size of the stomach to initially hold about three ounces. The procedure is permanent. Seventy to 80 percent of the stomach is surgically removed and a smaller stomach pouch is created. There is no rerouting of intestines. The shape of the new stomach pouch is often compared to a banana or the `sleeve` of a long-sleeved shirt.
The Laparoscopic Adjustable Gastric Band Procedure. This procedure, like the sleeve gastrectomy, is a restrictive procedure done by placing a silicone band around the upper part of the stomach, thereby creating a small pouch with a small opening through which the food passes. The size of the opening is adjusted by adding or removing saline water into or from a small port placed under the skin on the abdominal wall. Weight loss is generally slower than with the gastric bypass or sleeve gastrectomy due to the need for multiple adjustments during the first year.
For more information
Those considering weight loss surgery and want more information on St. Luke`s Bariatric Services can call St. Luke`s Bariatric Services at 610-628-8315 to speak with a team member or visit www.slhn.org. Free informational seminars on bariatric surgery are also offered monthly at St. Luke`s Hospital-Allentown Campus. An online informational seminar is also available. To register, call St. Luke`s InfoLink at 1-866 (STLUKES) 785-8537 or email InfoLink@slhn.org.