Robotic biliopancreatic diversion: Robot-assisted (hybrid) biliopancreatic diversion with duodenal switch

Scopinaro first described biliopancreatic diversion in 1979. One of its modifications, the biliopancreatic diversion with duodenal switch (BPD/DS), is the most effective operation for weight loss and resolution of obesity-associated medical conditions such as diabetes and hypertension. It remains uncommonly performed mainly due to its complexity and higher rates of complications compared to other bariatric procedures. We have used the robot over the last 13 years to perform a robot-assisted laparoscopic BPD/DS procedure and have been able to overcome many of the technical hurdles of this procedure. We have demonstrated a high level of effectiveness for both weight loss and comorbidity resolution, with acceptable morbidity. Our technique and experience are described in this chapter.