Obesity is the accumulation of excessive and abnormal fat in the body to such an extent that it harms health.

Obesity is a chronic disease that is becoming more and more common worldwide and is one of the main causes of health problems in most countries. It occurs in 18% of men and 20% of women in developed countries. The "body mass index", used in the identification of obesity, is calculated by dividing the body weight (kg) by the height squared (m²).

About Obesity

According to BMI, people are classified as underweight, normal weight, overweight, obese and morbidly obese.

  • Overweight people are people with a BMI in the range of 25-29.9,

  • Obese people are people with a BMI in the range of 30-40,

  • Morbidly obese are people with a BMI over 40.

Some health problems caused by obesity include:

  • Diabetes

  • Hypertension

  • High cholesterol

  • Heart disease (heart attack, etc.)

  • Stroke

  • Sleep apnea syndrome (interrupted breathing during sleep)

  • Asthma

  • Increased risk of cancer

Bariatric (obesity) surgery?

Treatment options for obesity can be categorized into four types:
  1. Restrictive procedures.

    These procedures, such as gastric banding and sleeve gastrectomy, limit the size of the stomach or its ability to expand, resulting in a feeling of fullness with less food. Gastric banding, also known as gastric banding, is usually performed laparoscopically, while sleeve gastrectomy involves reducing the size of the stomach into a tube.

  2. Malabsorptive Procedures

    These procedures reroute the upper part of the small intestine to bypass the small intestine, limiting absorption of nutrients. However, they are no longer widely used due to complications.

    • Malabsorptive Restrictive Plus Procedures:

      Gastric bypass surgery combines restrictive and malabsorptive techniques, altering the flow of food to reduce the capacity of the stomach and intestines. It is effective but requires a skilled surgical team.

  3. Procedures targeting the Saturation Center:

    These procedures focus on reducing appetite. An example is the use of an adjustable prosthesis implanted in the fundus of the stomach, such as ENDOGAST. Unlike gastric balloons, this method is less uncomfortable for patients, with fewer side effects such as nausea and pain.

    Among them, the implantation of gastric prostheses is usually practiced, offering effective weight loss with minimal discomfort.

Robotic bariatric (obesity) surgery?

Gastric bypass and gastric sleeve surgeries can be performed through open, laparoscopic, or robotic techniques. In open surgery, a long incision is made in the midline of the patient's abdomen. Laparoscopic procedures use a camera and thin instruments inserted through small incisions in the abdominal wall. Robotic surgery, an advanced form of laparoscopy, uses the da Vinci robotic surgical system.

With the da Vinci system, surgery is performed through small ports placed in the abdomen, similar to laparoscopy. The surgeon operates from the robotic system console, directing the surgical instruments, which carry out the surgeon's orders simultaneously.

Advantages of robotic surgery include:

  1. Improved visualization:

    The Da Vinci system provides 3D images with special cameras, providing depth perception during surgery. Compared to 2D laparoscopy images, this improves accuracy and reduces the risk of injuries. The enlarged operating area by 10-12 times allows detailed examination of anatomical structures in tight spaces.

  2. Flexible Instrumentation:

    Unlike traditional laparoscopic instruments, the arms of the robotic system can move freely in seven directions, with the ends of the instruments able to rotate 540 degrees. This endowrist system mimics the movements of human hands, facilitating complex operations in tight spaces. Additionally, the system's "vibration scaling" function prevents hand vibrations from affecting surgical instruments, minimizing errors during delicate procedures.

    In obese individuals, the fact that intra-abdominal adipose tissue is very high makes operations technically difficult and increases the risk of conversion to open surgery. Robotic surgery enables obesity surgery to be performed more safely and effectively thanks to the advantages mentioned above.