Background

Laparoscopic sleeve gastrectomy (LSG) has traditionally been performed with multiple fires of a laparoscopic stapler which can lead to spiraling of the stomach, kinks, or retained fundus. A 25cm stapler was developed in 2016 to perform single fire LSG. Bariatric centers across the country have adopted this for LSG. This video will demonstrate a single fire stapler sleeve gastrectomy using a robotic technique. This case presents a 48 year old male with a past medical history of longstanding class III obesity with a BMI of 55.19 and weight of 161 kg. He has a history of arthritis and restrictive lung disease. He had no previous abdominal surgeries and was a previous tobacco user. The patient had a longstanding history of class III obesity and was interested in pursuing a sleeve gastrectomy. This video demonstrates a robotic sleeve gastrectomy using a single fire stapler. The patient progressed well postoperatively. He tolerated a diet and was discharged home POD0. He was prescribed Eliquis for 28 days posteroperatively due to his elevated preop factor VIII as is consistent with our bariatric department's policy. He was seen in the office POD7 and was tolerating protein shakes and oral intake well. One and a half months postoperatively his weight had decreased 161 kg > 136.5 kg and BMI decreased 55.19 > 45.8. He continues to do well. This case demonstrates that a single fire stapler sleeve gastrectomy can be done safely and efficiently using a robotic technique.