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Published on November 14, 2013

Crozer’s Comprehensive Bariatric Surgery Program Offers Robotic Surgery


In Brief

 

  • Crozer is one of the few bariatric surgery programs in the area that offers minimally invasive robotic surgery for the surgical treatment of obesity as well as conventional laparoscopic and open surgical procedures.
  • The medical field’s view of obesity and bariatric surgery have broadened. Today, obesity is recognized as a disease by major non-surgical medical societies, including the American Medical Association.
  • Weight loss is one effect of bariatric surgery, but Crozer’s overall goal is to resolve patients’ metabolic diseases, including diabetes, high blood pressure, high cholesterol and sleep apnea.
  • Crozer’s Comprehensive Bariatric Surgery Program has been recognized as a Center of Excellence® (BSCOE) by the American Society for Metabolic and Bariatric Surgery (ASMBS). It also has been recognized for having one of the lowest rates of potentially avoidable complications (PACs) in the country by Blue Health Intelligence.

Significantly overweight persons who have tried to lose their excess weight using diet and exercise without success have a new option to treat this disease — and the metabolic disorders that often go with it, including diabetes and high blood pressure — in the Comprehensive Bariatric Surgery Program at Crozer-Chester Medical Center. Crozer is one of the few bariatric surgery programs in the area that offers minimally invasive robotic surgery for the surgical treatment of obesity as well as conventional laparoscopic and open surgical procedures.

Leon Katz, M.D.

Leon Katz, M.D.

“Thanks to the vision of Crozer-Keystone Health System and its leaders, Crozer was one of the first in the area to offer bariatric surgery and one of the first to offer robotic surgery,” says Leon Katz, M.D., FACS, medical director of Crozer’s Comprehensive Bariatric Surgery Program.

Crozer’s Comprehensive Bariatric Program was established in early 2007. Today, Katz treats approximately 60 percent of bariatric surgery patients using gastric bypass. Approximately 40 percent of patients are treated using sleeve gastrectomy, a procedure that has been available worldwide for approximately 10 years. Over the past six years, the team has performed more than 900 bariatric procedures.

Why Robotic Surgery?


At Crozer, Katz performs either the gastric bypass or sleeve gastrectomy procedure using the da Vinci® minimally invasive robotic surgical system, offering a new option for eligible bariatric surgery patients in addition to conventional minimally invasive laparoscopic surgery and traditional open surgery.

Katz says he is committed to performing minimally invasive bariatric surgery on every eligible patient. Compared with open surgery, robotic and laparoscopic surgery represent a less invasive approach using a small camera to view internal organs through small (1/4- to 1-inch) incisions. The potential benefits of robotics include less pain after surgery, more rapid recovery, smaller scars, fewer wound problems and less risk of infection, and reduced risk of hernia.

Ultimately, the specific type of bariatric surgery will depend on many considerations, and it will be a mutual decision between the patient and surgeon. “I believe that my patients, my Crozer associates and I are a team,” Katz says. “My obligation is to educate my patients about each type of procedure and discuss their goals and concerns and goals.”

Often, this includes a conversation about common misconceptions of robotic surgery versus the reality. “The most common misconception is that the robot performs the surgery on its own,” Katz says, “but in reality, the surgeon controls the instruments.”

Other people may have heard that robotic surgery is much safer and much better than conventional laparoscopic surgery. “As of today, there are no data that demonstrate a marked improvement in outcomes with robotic bariatric surgery compared with conventional laparoscopic bariatric surgery,” Katz says.

“So someone might ask, ‘... then why do it robotically?’ Number one, robotic surgery enables the surgeon to see the internal organs in three-dimensional or ‘3D’ high definition,” Katz explains. “That is something that we cannot do in conventional laparoscopic surgery.

“Number two, robotic surgery enables the surgeon to control four instruments at the same time — three surgical instruments and the camera,” Katz continues. “I believe this allows me to do the surgery in a more precise manner than with conventional laparoscopic surgery.”

In addition, Katz observes, some surgeons are able to learn and become proficient at robotic surgery more quickly than conventional laparoscopic surgery. Because of the ergonomic design of the equipment, robotic surgery may also be less physically tiring for the surgeon than conventional laparoscopic surgery, he says, “and this also may be beneficial for the patient.”

Katz says that patient safety and quality are foremost. Patients must meet strict medical guidelines to be eligible for all types of bariatric surgery. In addition, there are considerations for each type of surgical procedure, including age; health risk, such as heart or lung problems; the amount of weight a patient needs to lose; whether or not a patient has diabetes; and the patient’s lifestyle and the ability to commit to the required lifestyle changes.

It’s Not Only About Weight Loss


The medical field’s view of obesity and bariatric surgery have broadened within the past few years. Today, obesity is recognized as a disease by major non-surgical medical societies, including the American Medical Association. Bariatric surgery is viewed as a treatment for the metabolic disorders that often go with obesity, including diabetes and high blood pressure.

“Weight loss is a very desirable ‘side effect’ of bariatric surgery, but our overall goal is to resolve our patients’ metabolic diseases, including diabetes, high blood pressure, high cholesterol and sleep apnea,” Katz says.

Within the last five years, Katz says, it has become recognized that many patients who undergo gastric bypass or sleeve gastrectomy have a marked improvement in their underlying metabolic diseases — even before they have had major weight loss. “People with diabetes may go home with virtually normal blood sugar levels within two or three days following surgery,” he says. “People who have had diabetes for less than five years have an 85-percent chance of going into complete remission.”

Approximately 50 percent of patients are able to markedly reduce the need for blood pressure medication within six months of these procedures. Other conditions, such as high cholesterol, fatty liver disease (non-alcoholic steato hepatitis or “NASH”) and sleep apnea are also known to improve following gastric bypass and sleeve procedures, Katz says. Based on these observations, the American Society for Bariatric Surgery recently renamed itself the American Society for Metabolic and Bariatric Surgery (ASMBS).

A Comprehensive Program, a Lifelong Commitment


In addition to advanced surgical procedures, Crozer’s friendly and experienced multidisciplinary staff provides individualized preoperative counseling and ongoing postoperative support — including one-on-one nutritional counseling with a registered dietitian and a monthly support group.

Crozer’s Comprehensive Bariatric Surgery Program has been recognized as a Center of Excellence® (BSCOE) by the American Society for Metabolic and Bariatric Surgery (ASMBS). The program also has been recognized for having one of the lowest rates of potentially avoidable complications (PACs) in the country by Blue Health Intelligence.

Katz and his team believe that reaching and maintaining a healthy weight is a lifelong commitment that goes two ways: “My goal is to follow my patients for life,” he says.

Learn more about Comprehensive Bariatric Surgery at Crozer-Chester Medical Center or call 610-6198450.

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