Background

Super-super obesity, characterized by a BMI > 60 kg/m2, poses significant global health risks, often accompanied by chronic conditions such as diabetes, hypertension, and dyslipidemia. Robotic bariatric surgery has emerged as a crucial intervention, effectively reducing weight and decreasing associated health issues.

Methods

Present two cases of super-super obesity treated with robotic bariatric surgery, evaluating their progress and potential complications.

Results

In the first case, a 34-year-old male with difficult-to-control HPB, OSAS treated with a CPAP device, and generalized anxiety disorder. Initiated treatment at 250 kg and a BMI of 94.33 at age 34. Gastric sleeve surgery in March 2019 resulted in a remarkable one-year weight loss of 140 kg. In 2021, weight gain occurred due to a lapse in multidisciplinary management. The current weight is 160 kg with a BMI of 60.37, with correction of initial comorbidities.The second case features a 45-year-old female with a history of depressive disorder managed therapeutically and Robot-assisted radical hysterectomy for uncomplicated endometrial cancer. Starting treatment at 213 kg and a BMI of 83 in January 2020, gastric sleeve surgery led to a three-year weight reduction to 126 kg without setbacks. The current BMI is 49.21.

Conclusions

Robotic bariatric surgery proves an excellent alternative for super-super obesity, ensuring substantial weight loss. Identifying such patients and initiating an evaluation protocol for robotic bariatric surgery is crucial for improving their quality of life. However, considering the surgical challenges and increased complications, comprehensive follow-up by a multidisciplinary team is essential.