Robotic arm evolves stomach reduction surgery to treat morbid obesity

A 25-year-old male who has been obese since childhood, is 180 cm tall, weighs 138.5 kg, and has a body mass index (BMI) of 43, which is morbidly obese. Although the patient had tried various weight loss methods including diet, exercise, medication, traditional Chinese medicine, acupuncture, etc., none of them worked, so he went to the National Taiwan University Hospital for treatment. After careful evaluation by the National Taiwan University Hospital's advanced minimally invasive surgery team, it was decided to use a robotic arm to perform gastric reduction surgery. This not only has a small wound, less bleeding, and a quick recovery, it is also relatively safe and can achieve the goal of weight loss.

Dr. Yang Boren (left), a general surgeon at the National Taiwan University Hospital, said that the robotic arm can perform more precise separation, cutting and suturing in a narrow space than traditional laparoscopic surgery. (Photography by Huang Manying)

Dr. Yang Boren, a general surgeon at the National Taiwan University Hospital, said that morbid obesity is defined as a person's weight exceeding the ideal weight by 45 kg, or a BMI greater than or equal to 35, and the person already has complications caused by obesity, including diabetes, hypertension, stroke, and cardiovascular disease, which have become harmful to health and surgical treatment should be considered.

Currently, weight loss surgery can be divided into two types: restricting food intake and reducing absorption. Among restrictive surgeries, gastric banding and sleeve gastrectomy are the main representative surgeries, while among absorption-reducing surgeries, gastric bypass is the main representative surgery. Although gastric bypass has better effects, the operation is more complicated, may have complications, and has higher risks. Therefore, the patient decided to undergo robot-assisted laparoscopic gastric reduction and weight loss surgery.

Lin Mingcan, deputy director of the National Taiwan University Hospital, said that the National Taiwan University Hospital's advanced minimally invasive surgery team has used robotic arm surgery in clinical practice in recent years and has achieved excellent results. (Photography by Huang Manying)

Dr. Yang Boren said that the abdominal wall and abdominal cavity of morbidly obese patients are full of fat, the surgical space is narrow, and the stomach has rich blood circulation and is connected to many important organs. Gastric reduction and weight loss surgery requires cutting and suturing of the stomach in a narrow space, which is very difficult. In addition, obese patients usually have other physical diseases, and the risks of surgery and anesthesia are high, requiring close cooperation of the medical team to ensure safety. The robotic arm can rotate up to 540 degrees, and can perform more precise separation, cutting and suturing in a narrow space than traditional laparoscopic surgery, which can reduce the chance of bleeding and leakage at the sutures during surgery and increase surgical safety.

Lin Mingcan, deputy director of the National Taiwan University Hospital, said that robot-assisted surgery is a new surgical method that causes small wounds, recovers quickly, is highly stable, and does not cause fatigue. It can also achieve more precise separation, cutting, and suturing than traditional laparoscopic surgery. It can also alleviate the current problem of insufficient surgical manpower and provide better treatment effects for patients, so it is a win-win opportunity. In recent years, the National Taiwan University Hospital's advanced minimally invasive surgery team has used robotic arm surgery in clinical practice, transforming surgical operations from a "smart and labor-intensive" industry to a "high-tech" auxiliary industry. Combined with the development of robotic arm surgery, it will be able to improve Taiwan's high-quality medical quality.