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Bedside Stapling in Robotic Bariatric Surgery: A Cheaper, Safer Option?

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A new study is shaking up the world of robotic bariatric surgery by showing that a technique called “bedside stapling”—which involves using laparoscopic staplers manually at the patient’s bedside—could be just as effective as robotic staplers, but with a lot of added benefits. In fact, the study found that bedside stapling leads to fewer ICU stays, shorter hospital visits, and lower overall healthcare costs.

Dr. Alexander Abkin, a bariatric surgeon based in New Jersey, emphasizes that this finding could help make bariatric surgeries like gastric bypass or sleeve gastrectomy more accessible to patients in smaller hospitals, where resources may be more limited.

“Most patients who undergo bariatric surgery are looking for effective treatment at a lower cost,” Dr. Abkin says. “If bedside stapling can achieve the same results with fewer complications and lower healthcare utilization, it’s a win for both patients and the healthcare system.”

What Is Bedside Stapling?

In robotic bariatric surgery, staplers are used to secure parts of the stomach and intestines. Traditionally, robotic staplers—controlled by a robotic arm—have been seen as the gold standard. However, the new study compares robotic staplers with “bedside staplers,” which are manually controlled but still used during minimally invasive, robotic-assisted surgery. The key finding is that bedside staplers are just as effective, but they come with a significant reduction in costs and complications.

The Study’s Findings

In a large-scale study analyzing over 7,200 patients who had bariatric surgery in 2021, researchers found that patients who had bedside stapling were less likely to experience complications like needing a blood transfusion or staying in the ICU. In fact, these patients spent less time in the hospital overall, which meant lower healthcare costs.

Comparing the Two Techniques

The study compared two groups: one group used bedside staplers (1,603 patients), and the other used robotic staplers (5,665 patients). The results were eye-opening:

  • Patients using robotic staplers were more likely to need blood transfusions and stay in the ICU. They also had longer surgery times and higher costs.
  • Patients using bedside staplers had fewer ICU stays, shorter surgeries, and overall lower healthcare costs, even when accounting for differences in patient backgrounds.

Dr. Abkin agrees, saying, “It’s clear from the study that bedside stapling offers an opportunity to improve efficiency in surgery. The reduction in ICU stays and overall hospital costs is significant. This is crucial, especially in a healthcare landscape that’s becoming more focused on cost-effectiveness.”

What Does This Mean for the Future?

The study’s findings could have a major impact on how bariatric surgery is performed in the future. Bedside stapling could be a game-changer, particularly in smaller hospitals or places with limited access to high-end robotic technology. Dr. Billy’s study shows that the procedure is not only effective, but also more affordable, making it a potentially sustainable option for a broader range of healthcare settings.

In fact, Dr. Billy noted that bedside stapling might become a common practice as healthcare providers look to cut costs without compromising patient safety or outcomes. “As we move toward more cost-effective and efficient healthcare, bedside stapling is a promising option, especially in smaller hospitals where robotic systems might not be available,” he said.

The study highlights that bedside stapling could be a more affordable and just as effective alternative to robotic stapling in bariatric surgery. Fewer ICU stays, shorter hospitalizations, and lower costs could make this technique particularly attractive to hospitals looking to offer quality care without the high price tag. As Dr. Abkin puts it, “With healthcare costs rising, anything that can reduce the financial burden while still delivering top-notch care is a win for everyone involved.”

So, while robotic surgery still has its place, the future of bariatric surgery might just be going back to basics with a twist—and it’s looking like bedside stapling is here to stay.

Bariatric Surgery: The Most Effective Solution for Long-Term Weight Loss

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A recent study has clearly demonstrated that bariatric surgery is more effective than both lifestyle changes and medications for maintaining weight loss. Dr. Alexander Abkin, a bariatric surgeon in New Jersey, states, “When it comes to keeping weight off for the long term, surgery outshines medications and lifestyle changes without question.”

Presented at the 2024 annual meeting of the American Society for Metabolic and Bariatric Surgery, this analysis combined data from six major studies involving over 40,000 patients. It’s the first comprehensive review to focus on this critical comparison.

The study examined:

  • Bariatric Surgery: This included two procedures—Roux-en-Y gastric bypass and sleeve gastrectomy—encompassing nearly 25,000 patients.
  • Lifestyle Changes: Only about 723 patients were included in this category, relying primarily on diet and exercise.
  • Medications: The analysis also assessed GLP-1 medications, such as semaglutide and tirzepatide, with over 15,000 patients participating.

Lifestyle changes yielded an average weight loss of just 7.4%, and participants frequently regained that weight within a few years. “Lifestyle interventions fall short in providing lasting results,” Dr. Abkin explains.

When it comes to medications, while they can help some patients lose weight, the results are significantly less effective than those achieved through surgery. Many patients who use GLP-1 medications regain a substantial portion of the weight once they stop taking them. Roughly half of the weight lost was regained within a year after stopping injections; with continued injections, weight loss plateaued after 17 to 18 months. In contrast, bariatric surgery often leads to a loss of around 30% of body weight, with patients maintaining much of that loss over time.

This study indicates bariatric surgery is not just more effective than lifestyle changes but is also far superior to medications for long-term weight management. As Dr. Abkin adds, “For those struggling with obesity, surgery is the most effective path to achieving and sustaining significant weight loss, providing benefits that medications simply can’t match.”

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Woman Alleges Ozempic Led to Colon Removal

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A woman named Juanita Gantt has filed a lawsuit against Novo Nordisk, the company behind the diabetes drugs Ozempic and Wegovy, claiming that the medications caused serious side effects that weren’t adequately warned about on the label.

Gantt shared her story, explaining that her doctor initially prescribed Wegovy, and later Ozempic, due to concerns she was at risk of developing diabetes. At the time, she weighed 242 pounds. For a while, Gantt said the drugs worked well for her: “I was feeling fine. I enjoyed the days that I didn’t have to worry about my appetite. I didn’t have cravings. I just felt like I was doing something positive for myself.”

However, in October 2023, Gantt experienced a life-threatening complication. She collapsed at home and was rushed to the hospital, where doctors discovered that parts of her large intestine had died and needed to be removed. During her recovery, Gantt’s heart stopped, and she now lives with an ileostomy bag, a medical device that helps her body eliminate waste.

Gantt said she had no warning that such serious complications could happen. The main ingredients in Ozempic and Wegovy—semaglutide and liraglutide—are part of a class of drugs called GLP-1 receptor agonists. These drugs can slow digestion, which can sometimes lead to severe digestive issues if taken long-term. Last year, similar drugs were linked to cases of stomach paralysis, a condition where digestion is dangerously delayed.

Dr. Alexander Abkin, a bariatric surgeon in New Jersey, emphasizes the importance of understanding all treatment options for weight loss. “Medications like Ozempic and Wegovy can be effective in managing weight, but they do come with risks, as we’ve seen in recent cases. Bariatric surgery, on the other hand, has been proven to offer long-term weight loss benefits with a more predictable outcome. For many patients, especially those with severe obesity, surgery can provide a safer and more effective solution.”

Novo Nordisk, the drug’s manufacturer, responded to the lawsuit, stating that they are sympathetic to Gantt’s health challenges but believe the lawsuit has no merit. They also mentioned that their GLP-1 medications have been used safely for many years and that potential risks are clearly outlined in the product’s labeling.

Dr. Abkin adds, “While medications can help in specific cases, bariatric surgery remains one of the most reliable ways to achieve significant, lasting weight loss. It not only helps patients lose weight but also resolves conditions like diabetes, sleep apnea, and hypertension. Patients need to weigh all options and consider what will provide them with the safest, most sustainable results.”

Bariatric Surgery Lowers Risk of Serious Heart Problems and Death in Patients Obstructive Sleep Apnea

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Bariatric surgery, which helps people lose weight, appears to significantly lower the risk of serious heart problems and death for those who are obese and suffer from moderate-to-severe sleep apnea, according to a recent study. This research, known as the MOSAIC study, found that people who had the surgery reduced their risk of major cardiovascular issues by 42% and their overall risk of death by 37% compared to those who didn’t undergo the surgery. Read more

Conversion of Sleeve Gastrectomy to Gastric Bypass: Improved GERD Management and Weight Loss

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Sleeve Gastrectomy has become a widely adopted procedure for weight loss. However, its success is sometimes overshadowed by complications such as postoperative gastroesophageal reflux disease (GERD) and weight recurrence. As a result, converting Sleeve Gastrectomy to Roux-en-Y Gastric Bypass has emerged as a potential solution. To explore the effectiveness of this conversion, a comprehensive study was conducted across 41 hospitals in Michigan from 2014 to 2022.

The study highlights several significant benefits of converting sleeve gastrectomy to Roux-en-y Gastric Bypass:

Improved GERD Symptoms

One of the primary motivations for converting Sleeve Gastrectomy to Roux-en-Y Gastric Bypass is the management of GERD. Dr. Alexander Abkin, a bariatric surgeon based in New Jersey, emphasizes the effectiveness of this approach. “The conversion to Gastric Bypass can drastically reduce GERD symptoms. Our patients frequently report substantial relief after the procedure,” says Dr. Abkin. The study supports this, with GERD-HRQL scores dropping significantly from 24.6 to 6.6. Additionally, the need for anti-reflux medication decreased from 74% to 27% within a year of conversion.

Significant Weight Loss

Weight management is another crucial aspect where conversion shows notable improvement. Patients experienced an average weight loss of 68.4 pounds, which translates to a 24.3% reduction in total body weight and a 51.5% decrease in excess body weight. According to Dr. Abkin, “The conversion not only addresses GERD but also substantially aids in further weight reduction, which can be crucial for long-term success in managing obesity.”

The findings from this large-scale study demonstrate that converting Sleeve Gastrectomy to Roux-en-Y Gastric Bypass offers significant benefits, particularly in managing GERD and achieving substantial weight loss. The procedure has proven effective in alleviating GERD symptoms and reducing the reliance on anti-reflux medications. However, as Dr. Abkin advises, “Every patient’s case is unique, and the decision to convert should be tailored to the individual’s overall health profile and comorbidities.”

This research underscores the importance of personalized treatment strategies in bariatric surgery and offers valuable insights for patients and surgeons considering conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass.

Long-Term Success of Roux-en-Y Gastric Bypass: What You Need to Know

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If you’ve been considering Roux-en-Y Gastric Bypass (RYGB) for weight loss, you might wonder how effective it is in the long run. A recent study looked at patients who had the surgery between 2008 and 2009 and followed them for up to 15 years. Here’s what they found, with insights from Dr. Alexander Abkin, a bariatric surgeon from New Jersey.

Long-Term Weight Loss

The study included 264 patients, mostly women, and assessed how well they maintained weight loss over 15 years. The results were promising. On average, patients lost about 31.5% of their total body weight in the first year, and they managed to keep losing more than 20% of their body weight throughout the follow-up period.

Dr. Abkin explains, “Roux-en-Y Gastric Bypass is known for its effectiveness in the short term, but this study really shows its long-term potential. Patients can maintain significant weight loss over many years, which is crucial for long-term success.”

Improvement in Health Conditions

The surgery didn’t just help with weight loss—it also improved several obesity-related health conditions. For example, about 61% of patients saw their type 2 diabetes go into remission, 47% saw improvements in their cholesterol levels, and 40% had their high blood pressure resolved. However, some conditions did return over time, with 24% of patients experiencing a return of diabetes and 18% seeing their high blood pressure come back.

Dr. Abkin adds, “One of the great benefits of Roux-en-Y Gastric Bypass is its ability to significantly improve or resolve health conditions related to obesity. However, it’s important to keep monitoring and managing these conditions, as some patients might experience a recurrence.”

Challenges and Considerations

The study also noted that about 51% of patients saw some weight regain over 15 years. Factors like higher initial body mass index and having type 2 diabetes before the surgery were linked to a higher chance of weight regain.

Dr. Abkin advises, “While Roux-en-Y Gastric Bypass can offer lasting results, it’s not a cure-all. Maintaining weight loss and health improvements requires ongoing effort and regular check-ups. Understanding the factors that contribute to weight regain can help in managing and overcoming these challenges.”

Conclusion

Overall, the study confirms that laparoscopic Roux-en-Y Gastric Bypass offers significant and lasting benefits for weight loss and improving obesity-related health conditions. Dr. Abkin sums it up: “Roux-en-Y Gastric Bypass remains a promising option for long-term weight management and health improvement. For those considering this surgery, it’s important to be aware of both its benefits and the need for long-term commitment to maintain results.”

This research highlights the effectiveness of Roux-en-Y Gastric Bypass over a lengthy period, offering valuable insights for anyone looking into weight loss surgery options.

Non-Surgical Weight Loss

Weight Loss Surgery vs. Medication: What’s Better for Long-Term Health?

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New research reveals that weight loss surgery, specifically Bariatric Metabolic Surgery (BMS), can provide a significant survival advantage over the popular diabetes medication class, GLP-1 receptor agonists (GLP-1 RAs), for adults with obesity and diabetes of up to 10 years. Read more

Cardiovascular Disease Expected to Increase in the Coming Decades

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Heart disease has held the title of the world’s leading cause of death for over a century. Unfortunately, the future does not seem to offer any relief from this statistic. Read more

Dr. Abkin Joins New York Bariatric Group

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We’re thrilled to announce some exciting news! Advanced Laparoscopic Surgeons of Morris has officially joined New York Bariatric Group (NYBG), the nation’s leading provider of bariatric services. This collaboration marks a significant stride in our dedication to delivering cutting-edge surgical techniques and exceptional patient care.

Dr. Alexander Abkin and his team from Advanced Laparoscopic Surgeons of Morris will now be part of the esteemed NYBG team, which boasts 25 renowned bariatric surgeons. NYBG is well known for its patient-centered approach to weight-loss, offering a comprehensive range of services including expedited one-day presurgical assessments, aftercare programs, support groups, and nutritional guidance.

In addition, the introduction of ambulatory surgery centers (ASC) will greatly enhance the patient experience, providing a state-of-the-art facility for same-day surgical procedures. These ASCs offer a superior alternative to traditional hospital stays, ensuring a safe and comfortable surgical journey.

We’re genuinely excited about this partnership and the opportunities it presents to enhance our service to you. If you have any questions or wish to schedule an appointment, please call 973-410-9700.

Sincerely,

Dr. Alexander Abkin
Advanced Laparoscopic Surgeons of Morris

As Zepbound Shortage Grows, Eli Lilly Says No Immediate End Is In Sight

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As the demand for weight loss medications surges, the availability of Zepbound, manufactured by Eli Lilly, faces significant shortages, with no immediate solution in sight. The FDA approved Zepbound in November, offering a new option for weight loss alongside Novo Nordisk’s Wegovy. However, despite earlier assurances from Lilly’s CEO, Dave Ricks, shortages have become widespread just months after approval. Read more