DS/SADI

Robotic-assisted (RA) metabolic and bariatric surgery (MBS) has gained popularity in recent years. The use of RA surgery in MBS, however, remains controversial because of prolonged operation lengths, conflicting results related to its outcomes compared to standard laparoscopic techniques, and cost-related issues. Compared to sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), the most performed MBS procedures, biliopancreatic diversion with duodenal switch (BPD-DS) is performed in a small subset of patients because of its complexity, increased complication rates, and postoperative nutritional deficiencies. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S), a variant for BPD-DS, has recently emerged as an endorsed procedure by the American Society for Metabolic and Bariatric Surgery (ASMBS) and is gaining popularity as a primary procedure and a revisional procedure. The objective of this chapter is to discuss the technical aspects of performing robotic-assisted BPD-DS and robotic-assisted SADI-S.