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Case Report | DOI: https://doi.org/10.31579/2690-1919/356
1General, Gastric and Minimally Invasive Surgeons at Vila Nova Star Hospital, São Paulo Brazil.
2Medical Student at Albert Einstein Medical School (FICSAE), São Paulo Brazil.
3Doctor at Faculty of Medical Sciences at the National University of La Plata, Buenos Aires, Argentina.
*Corresponding Author: Marina Gabrielle Epstein, 450 Rocio St, Zipcode: 04552-000, Vila Olímpia São Paulo/SP Brazil.
Citation: Marina G. Epstein, Gabriel Garbato, Gabriel Maccapani, Camille D. Benatti, Ivan C. Batista1, et al, (2024), Robot Assisted Bariatric Surgery in a Superobese Patient, J Clinical Research and Reports, 15(2); DOI:10.31579/2690-1919/356
Copyright: © 2024, Marina Gabrielle Epstein. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 20 February 2024 | Accepted: 04 March 2024 | Published: 11 March 2024
Keywords: music therapy, psychological well-being, victims of violence.
Objective: to determine the effects of a music therapy program on the psychological well-being of women victims of violence in El Milagro populated center of Trujillo.
Materials and methods: this research had a pre-experimental design, for this we worked with a sample of 21 women victims of violence belonging of the El Milagro populated of Trujillo. The information was collected through the Carol Ryff Psychological Well-Being Scale, and the Music Therapy Program.
Results: The findings of this study indicate that the music therapy program significantly impacted the psychological well-being of women victims of violence. Additionally, statistically significant differences were found between the pre and post-test, of the Self-concept dimension.
Conclusions: The music therapy program has a positive and significant impact on the psychological well-being of women victims of violence in the El Milagro populated center of Trujillo.
Obesity is a chronic disease, with multifactorial etiology, and complex treatment involving psychological, behavioral, social and genetic factors, associated with multiple metabolic and cardiovascular complications [1]. In Brazil, more than 51% of the population is overweight, with approximately 22 million obese people, which corresponds to 17% of the population, and approximately six million are morbidly obese. Surgical treatment of obesity is indicated in patients with a higher BMI than 40 kg/m2 or above 35 kg/m2 who present comorbidities [2].
To present a video of a robotic bariatric surgery patient with super obesity (BMI above 50 kg/m2) with comorbidities.
Case Report
Female patient, 38 years old, with BMI of 55.3 kg/m2 and weight of 195 kg, with systemic arterial hypertension and severe chronic venous insufficiency associated with varicose ulcers of the lower limbs. She was electively hospitalized for a robotic gastroplasty (Figure 1) with Roux-en-Y reconstruction. Patient was aware that there would be a high probability of performing vertical gastroplasty, depending on the inventory of the cavity. The patient underwent general anesthesia and during inventory of the cavity, intense retractile mesenteritis was identified and, aiming for patient safety, a robotic vertical gastroplasty was performed (da Vinci XI Robot). Docking took approximately 4 minutes
Figure 1: Trocars set-up and robot docking
The greater gastric curvature was opened with Synchroseal, starting in the distal portion of the gastric body, continuing proximally towards the esophagus and then distally to the pylorus. The part of the gastric fundus
attached to the diaphragmatic crura was released in its posterior portion. After complete release, the stomach was stapled with a 60mm linear stapler for complete gastric section (Figure 2). In super obese patients, we perform routine sutures with scarp thread.
Figure 2: Staple line: black tri-staple 60 mm
The surgery was successful, there were no complications, with a total operative time of 90 minutes (Figure 3). Console time was of 60 minutes. The patient evolved satisfactorily and was discharged 36 hours after the procedure. He is currently well, undergoing outpatient follow-up and without the need for antihypertensive medication.
Figure 3: Final aspect of the surgery
Robotic surgery has as one of its advantages more adequate and comfortable ergonomics and the three-dimensional view of intra-abdominal anatomy, which makes dissection easier, especially of delicate structures, facilitating procedures in obese and especially super-obese patients [3,4]. Studies state that the robotic technique offers greater precision in certain procedures, which could be related to a lower rate of complications and pain5. On the other hand, disadvantages may include high financial costs and longer surgical times [6].
Robotic bariatric surgery proved to be a safe procedure, presenting satisfactory postoperative results.
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