Early Results from Robotic Gastric Bypass Operation

“It’s amazing”, Robyn Blake told me in the office today. She is just one week from her robotically assisted laparoscopic Roux en-Y gastric bypass and she is thrilled with her results. ‘I only took one pain pill a day for the first 2 days after I was discharged from the hospital.”

“The results are not subtle,” Mike Palasek, CRNFA who assisted with each of these operations told me today. “The patients who had their operation robotically are having much less pain.”

We have now completed our first four robotically assisted gastric bypass operations. Both are doing very well. Two of these patients went home the day after their operation instead of two days later. The patients appear much more comfortable the day after the operation.

Overall I am very impressed with these very early results. There are only 4 incisions and these are smaller and healing well without a drain or staples.

I agree with Robyn, the results are amazing.

Update on the Use of the da Vinci Surgical Robot

Last Tuesday, September 14, 2010, I was privilegded to perform 2 gastric bypass operations with the assistance of the da Vinci surgical robot. Although it is always challenging to begin to use new technology, both patients did well and one left the hospital after only one night stay.

The following is an exert from an email sent out by a representative of the company that makes the da Vinci robot to some of the Medical staff at our hospital. I thought you might be interested in this anouncement:

"OhioHealth has established itself as a leader in robotic surgery and Dr. Myers has established himself as a leader in bariatric surgery. This is another application where da Vinci is helping surgeons deliver minimally invasive surgery to a broader base of patients every day. Dr. Myers gave the following reasons for using the da Vinci for his gastric bypass procedures:

1. Stronger anastomosis
2. Patients are less likely to bleed
3. Less incisions - reduced from 5 to 4 with about 50% reduction in incisional "footprint"
4. Less pain at trochar sites
5. No need for largest incision to pass circular stapler

Dr. Erik Wilson from the University of Texas Medical School at Houston proctored Dr. Myers with the use of the dual console da Vinci Si system."

This important device will be able to help make this operation even safer and better. I will have the oportunity to use the robot to perform a gastric bypass for three more patients in the coming week.

Learn more about the da Vinci robot at www.IntuitiveSurgical.com

Preparing to Perform Robotic Assisted Bariatric Surgery

Preparing to Perform Robotic Assisted Bariatric Surgery

My wife and I were at my parent’s home last weekend. Our conversation included my plan to begin performing robot assisted bariatric surgery. They asked a great question, “How have you been training to use the robot?”

I thought you might be interested in my response.



First, it is important to remember that I have been performing the Laparoscopic Roux en-Y Gastric bypass for over 7 years and have performed nearly 800 of these operations.

Second, I plan to begin by performing only a part of the operation using the robot.

Third, using new advanced technology to perform this operation is much like an experienced professional pilot training to use a new airplane to fly a familiar air route.

As you might imagine Riverside Methodist Hospital has a pathway each surgeon is required to complete to become credentialed to perform operations with the assistance of a robot. I have exceeded the requirements and followed the following 10 steps in the path to preparation:

1). Observed two operations performed by Dr. Michelle Toder in Bangor Maine in July 2010 and was very excited by the capability of this remarkable instrument.

2). Informed the hospital of my interest in robotic surgery

3). Reviewed about at least 8 hours of video of the operation performed using the robot

4). Observed an operation with Dr. Burges at Riverside

5). Completed an all day training session performing several operations with a certified instructor

6). Logged at least 8 hours of independent practice on the robot

7). Choreographed each step of the operation with the operation room staff during a mock operation

8). Received temporary privileges to perform robotic surgery from Riverside credentials committee

9). Obtained consent from the first 2 patients to perform their operations using the robot

10). Arranged for Dr Erick Wilson, a very experienced robotic surgeon from Houston, Texas, to be present in the operating room during the first two operations using the robot as my “proctor” or supervisor tomorrow, (9/14/2010)

Now I am ready to get started! Maybe I should watch “Top Gun” once again before we start the operations!

Robotic Surgery Holds Great Promise for Bariatric Surgery Patients.

As many of you know, qver the last several weeks I have been observing robotic surgery, logging time practicing on the newest robot and doing a lot of planning for my first robotic gastric bypass operation scheduled on September 14th , just a little over two weeks from now.

Today I spent the entire day training in the robotic laboratory at Good Samaritan Hospital in Cincinnati, Ohio. It was an intense day with many hours in the console of the robot performing several operations, learning to “dock” the robot to the ports and instruments and learning much more about this elegant and sophisticated machine.

The training will continue nearly each day in preparation for the first operations but everything is progressing very smoothly.
I must say, I believe the da Vinci Robot is very likely to bring considerable value to my gastric bypass patients. I am even hopeful that many will be able to go home the day after surgery since I believe I will be able to decrease the incision “footprint” by about 50% and there should be even less discomfort involved with this operation.

Congratulations to Intuitive Surgical, Inc. for many improvements in the newest model of the da Vinci robot!

Posted by Stephan Myers, MD, FACS, bariatric surgeon, Columbus Ohio

Da Vinci Robot and Bariatric Surgery

I have been pondering the possible place for the Da Vinci Robot in bariatric surgery for a few years. Although it is an expensive device, (about 2.5 Million dollars per robot), I am now convinced there is very real value for bariatric patients and their surgeons.

First, he patient is likely to benefit by having less incisions decreasing from four ¾ inch incisions and one 1 ¼ inch incision to two ¾ inch incisions and two ½ inch incisions. This alone should decrease pain and shorten recovery time. In addition the robot “remembers” the point each device passes through the abdominal wall and pivots at this point decreasing the trauma to the abdominal wall tissues thus decreasing pain even more.

Second, the surgeon can see better since the view is a 3 dimensional view instead of the 2 dimensional view with standard laparoscopy. The better the surgeon can see the safer the operation. Who wouldn’t like there surgeon to see as well as possible during their operation?

Another issue is the reduced wear and tear on the surgeon. Operation on persons of size is physically demanding and allowing the robot to take the physical load while the surgeon is guiding every move of the robot while sitting comfortably at the console may add years to the length of a surgeons career.

Two weeks ago I spent the day in New England with Dr. Toder who performed 2 gastric bypass operations that day. It was clear to me that using the Da Vinci robot would be of benefit to our patients.

Riverside presently has 2 robots and they will be installing the third and most up to date robot in the operating room I usually use to do bariatric surgery operations by the middle of September 2010.

Over the next 6 weeks I will be training on this new instrument. I am hoping the robot will reduce the number of days a patient stays in the hospital from 2 days to one day.

I will post regular updates as we make this transition to this advanced technique to keep you informed.