Bariatric Surgery

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Learn about bariatric surgery and understand your options

Aim for a lasting change

Your weight could be holding you back from enjoying life to the fullest. Obesity can take a physical and emotional toll that may be truly worrying to you and your family. When left untreated, obesity can lead to heart disease, type II diabetes, and other chronic diseases.¹ If dieting, exercise, and medicine alone haven’t worked for you, it may be time to consider an additional option.

If you’re considering surgery, you may be surprised to learn that more than 1.3 million people underwent bariatric surgery to lose weight from 2011 through 2017.²

According to a study of 164,247 patients, one year after surgery patients who underwent a sleeve gastrectomy lost an average of 29.5 percent of their total body weight, while those who had Roux-en-Y gastric bypass lost an average of 34.2 percent.³ Sleeve gastrectomy and Roux-en-Y gastric bypass are two of the most common bariatric surgeries.⁴

Surgery alone is not enough. You must follow the recommended changes from your healthcare team after surgery for you to make a lasting change.

Understanding your options

There are many ways to lose weight that you can explore with your doctor, such as changing your diet, exercising, medication, and surgery. If you’re considering surgery, your surgeon should discuss your options with you.

Sleeve gastrectomy reduces your stomach size by about 80 percent to limit the amount of food it can hold. You may lose weight because you can only eat small amounts of food.⁴ Roux-en-Y gastric bypass reduces your stomach size while also rerouting your small intestine to decrease the amount of nutrients your body absorbs. You may lose weight by eating less and absorbing fewer nutrients.4 Both procedures may cause favorable changes in your gut hormones to reduce appetite and improve feeling full.⁴

Both sleeve gastrectomy and gastric bypass surgeries are almost always performed using minimally invasive techniques—either laparoscopic surgery or robotic-assisted surgery, possibly with da Vinci® technology.⁵ Surgeons perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions. To perform a laparoscopic bariatric surgery, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

How da Vinci works

Surgeons can perform both sleeve gastrectomy and Roux-en-Y gastric bypass surgeries using robotic-assisted surgery with da Vinci technology. With da Vinci, your surgeon sits at a console next to you and operates using tiny instruments through a few small incisions.

A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci System in real-time to bend and rotate the instruments with precision.

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

More about da Vinci

Why surgery with da Vinci?

A review of published studies suggests potential benefits of gastric bypass surgery when using da Vinci technology include:

Patients experience complications after surgery at a similar, though sometimes lower, rate as patients who had a laparoscopic procedure.^6-15
Patients experience complications during surgery at a similar rate as patients who had a laparoscopic procedure.^6-8,11,13,14
There is a similar, though sometimes shorter, length of stay in hospital compared to laparoscopic surgery.^5,6,9-15

All surgery involves risk. You can read more about associated risks of bariatric surgery here.

Questions you can ask your doctor

What types of weight-loss surgery are available and which is best for me?
What is the difference between laparoscopic and robotic-assisted surgery?
Can you tell me about your training, experience, and patient outcomes with da Vinci?
How will I feel after surgery?
What changes should I make after surgery?

More about general surgery with da Vinci

Robotic-assisted surgery with da Vinci technology is used in many different types of procedures by general surgeons.

About the specialty

^{1. Obesity. World Health Organization. Web. 23 January 2019.}

^{2. Estimate of Bariatric Surgery Numbers, 2011-2017. American Society of Metabolic and Bariatric Surgery. Web. 19 December 2018}

^{3. Sczepaniak JP, Owens ML, et al. Comparability of weight loss reporting after gastric bypass and sleeve gastrectomy using BOLD data 2008-2011. Obes Surgery. 2015 May;25(5):788-95. doi: 10.1007/s11695-014-1496-3}

^{4. Bariatric Surgery Procedures. American Society of Metabolic and Bariatric Surgery. Web. 19 December 2018}

^{5. Bariatric Surgery in Class I Obesity Published September 2012 (… the laparoscopic approach has largely replaced open surgery…)}

^{6. Ahmad, A., Carleton, J.D., Ahmad, Z.F. et al. Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital. Surg Endosc. 2016 Sep;30(9):3792-6. doi: 10.1007/s00464-015-4675-y.}

^{7. Ayloo, S., Roh, Y., Choudhury, N. Laparoscopic, hybrid, and totally robotic Roux-en-Y gastric bypass. J Robot Surg. 2016 Mar;10(1):41-7. doi: 10.1007/s11701-016-0559-y.}

^{8. Benizri, E.I., Renaud, M., Reibel, N. et al. Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study. Am J Surg. 2013 Aug;206(2):145-51. doi: 10.1016/j.amjsurg.2012.07.049.}

^{9. Myers, S.R., McGuirl, J., Wang, J. Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes. Obes Surg. 2013 Apr;23(4):467-73. doi: 10.1007/s11695-012-0848-0.}

^{10. Smeenk, R.M., van 't Hof, G., Elsten, E. et al. The Results of 100 Robotic Versus 100 Laparoscopic Gastric Bypass Procedures: a Single High Volume Centre Experience. Obes Surg. 2016 Jun;26(6):1266-73. doi: 10.1007/s11695-015-1933-y.}

^{11. Stefanidis, D., Bailey, S.B., Kuwada, T. et al. Robotic gastric bypass may lead to fewer complications compared with laparoscopy. Surg Endosc. 2018 Feb;32(2):610-616. doi: 10.1007/s00464-017-5710-y.}

^{12. Wood, M.H., Kroll, J.J., Garretson, B. A comparison of outcomes between the traditional laparoscopic and totally robotic Roux-en-Y gastric bypass procedures. J Robot Surg. 2014 Mar;8(1):29-34. doi: 10.1007/s11701-013-0416-1.}

^{13. Buchs, N.C., Azagury, D.E., Pugin, F. et al. Roux-en-Y gastric bypass for super obese patients: what approach? Int J Med Robot. 2016 Jun;12(2):276-82. doi: 10.1002/rcs.1660.}

^{14. Buchs, N.C., Morel, P., Azagury, D.E. et al. Laparoscopic versus robotic Roux-en-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014 Dec;24(12):2031-9. doi: 10.1007/s11695-014-1335-6.}

^{15. Hagen, M.E., Pugin, F., Chassot G. et al. Reducing cost of surgery by avoiding complications: the model of robotic Roux-en-Y gastric bypass. Obes Surg. 2012 Jan;22(1):52-61. doi: 10.1007/s11695-011-0422-1.}

Disclosures and Important Safety Information

Surgical Risks

Risks associated with bariatric surgery (gastric bypass {stomach reduction surgery}, sleeve gastrectomy and duodenal switch) include leaking and/or narrowing at the spot where two parts of the bowel were reconnected, leaking from where the bowel is cut, malnutrition, dumping syndrome (food moves too quickly into small intestine), dehydration, need for supplementation of vitamins, minerals and protein.

Important Safety Information

Patients should talk to their doctor to decide if da Vinci® sSurgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options and associated risks in order to make an informed decision.

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques which could result in a longer operative time and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety.

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

da Vinci Xi® System Precaution Statement

The demonstration of safety and effectiveness for the specific procedure(s) discussed in this material was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of cancer (overall survival, disease-free survival, local recurrence) or treatment of the patient’s underlying disease/condition. Device usage in all surgical procedures should be guided by the clinical judgment of an adequately trained surgeon.

Medical Advice and Locating a Doctor

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Other options may be available and appropriate. Only a doctor can determine whether da Vinci surgery is appropriate for a patient’s situation. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision.

Surgeons experienced with the da Vinci system can be found using the Surgeon Locator. Intuitive Surgical provides surgeons training on the use of the da Vinci system but does not certify, credential or qualify the surgeons listed in the Surgeon Locator.

Published Evidence

In order to provide benefit and risk information, Intuitive Surgical reviews the highest available level of evidence on procedures named above. Intuitive Surgical strives to provide a complete, fair and balanced view of the clinical literature. However, our materials should not be seen as a substitute for a comprehensive literature review for inclusion of all potential outcomes. We encourage patients and physicians to review the original publications and all available literature in order to make an informed decision. Clinical studies are typically available at pubmed.gov.