Despite the lack of tactile feedback, the long set-up time, long learning curve, and continued high costs, robotic systems can be used in particularly challenging surgeries. According to our criteria and our results, the learning curve for a console surgeon for sleeve gastrectomy check details should be completed by around 20 cases. Once this point has been reached and the operator is confident in suturing and docking with the robot, more challenging techniques can be considered. In our experience, sleeve gastrectomy can be achieved safely and could be considered as a preliminary step prior to attempting more complex bariatric procedures through a robotic assisted approach. However, partial RGBP may also be reasonable as an initial procedure. Conflict of Interests The authors declare that they have no conflict of interests concerning this paper.
Acknowledgment The Dr. Ramon Vilallonga Foundation has participated with the financial support to prepare the paper. (http://www.fundacioramonvilallonga.org/).
Currently, it is believed that about one-third of the adult population in United States is obese, and this percentage is rising. As a result, we are witnessing a concurrent increase in the number of bariatric procedures performed for treating obesity in this country . For many, weight loss surgery is the treatment modality of choice for the severely obese . It has been shown that surgical interventions significantly improve the quality of life and reduce long-term morbidity and mortality .
The data collected over an 18-year period (1987�C2004) from the International Bariatric Surgery Registry shows that more and more people are choosing surgery, and those undergoing surgery are now older and much heavier . Although there are obvious benefits, surgery is certainly not without risks. As many as 25% of patients undergoing weight loss surgery require repeat surgery, either due to complications or failed weight loss. These patients are particularly at high risk, as the morbidity following these reoperative procedures is often high (9�C22%), and mortality is not insignificant (0�C1.4%) . The reported incidence of intussusception following gastric bypass surgery is about 0.1�C0.3% . We believe that the true incidence is higher, Anacetrapib and it will further rise in the next few years. This is because firstly, the number of gastric bypass surgeries performed is increasing rapidly, and secondly there is an increased awareness about this complication. More and more cases are being reported, and there are now better imaging modalities to detect this complication early. CT scans often reveal the classic ��target sign�� or ��tube within a tube�� sign (Figures 1(a) and 1(b)).