by Danny Shouhed
Incision Sleeve Surgery
by Danny Shouhed
Incision Sleeve Surgery
An expert in robotic bariatric surgery, Dr. Shouhed recently introduced a new technique for performing a robotic sleeve gastrectomy – the most common and most requested weight loss operation in the world. During the robotic-assisted surgery, called RoboWHISS, Dr. Shouhed makes four small incisions below the patient’s waistline to complete the sleeve gastrectomy. Unlike a traditional robotic sleeve gastrectomy, where small incisions are made near a patient’s belly button, this minimally invasive technique places incisions below the waistline and allows the small scars to remain hidden from view when wearing shorts or a bathing suit. This allows patients to keep the operation completely confidential.
“It is similar to a c-section scar since they are so low, but only a fraction of the size. It gives patients an opportunity to keep their surgery confidential. A lot of patients don’t want people to know they had bariatric surgery to lose weight, so this technique makes it possible for them to hide their procedure.”
– Dr. Shouhed
The ‘scarless’ robotic sleeve gastrectomy is a revolutionary and state-of-the-art procedure that is performed like the traditional sleeve gastrectomy on the inside, with hidden incisions on the outside. Unlike traditional hidden incision surgery where the scar is hidden in the belly button, this procedure leaves small scars in the waistline area so patients can keep their surgery completely confidential.
The sleeve gastrectomy removes up to 80% of the stomach, creating a banana-shaped tube versus a large pouch. The operation induces weight loss through restriction as well as metabolic changes that affect hormones and help with hunger and satiety. This operation is currently the most common operation performed around the world.
A gastric bypass results in a small gastric pouch, while also rerouting the intestinal tract. Weight loss occurs through restriction, decreased absorption of calories, and most importantly, changes related to metabolic hormones.
Revisional bariatric surgery is typically performed for complications or side effects resulting from the original operation or from weight regain. Many options exist for revisional surgery, whether it is revision of the Lap Band, sleeve gastrectomy, gastric bypass, duodenal switch or vertical banded gastroplasty. It is critical to undergo a proper pre-operative work-up to determine the best option for each individual patient.
The two most common bariatric operations, gastric bypass and sleeve gastrectomy, are combined, in theory, to perform the duodenal switch. A duodenal switch results in a sleeve stomach while offering extensive intestinal bypass for very effective weight loss and control of diabetes. It is the most effective operation for obesity and diabetes but also has the most side effects.
The intragastric balloon is a device that is inserted and inflated in the stomach to reduce space and impact the sensation of fullness. This reduces the space in the stomach to help manage portion control when eating and slowing the digestion process.
Injectable weight loss medications, such as, Ozempic, Wegovy and Saxenda have shown to be very successful with minimal side effects. These belong to a class of medications called incretins, which activate GLP-1 receptors to stabilize glucose levels. The FDA recently approved Mounjaro, which activates both GLP-1 and GIP receptors and has been shown to be twice as effective as the other injectables with even less side effects. We work together with every patient to find an individual treatment plan that works best for them.
Dr. Shouhed is a pioneer of robotic bariatric surgery. He has trained and proctored over 90% of the bariatric surgeons in Southern California in robotic surgery and trained and proctored 100’s of surgeons across the United States. His expertise in robotic surgery allowed him to revolutionize bariatric surgery by offering a new technique, the RoboWHISS, that hides all the scars from surgery, making the procedure completely confidential. His training includes general surgery residency at Cedars Sinai and fellowship training at Mount Sinai Hospital in New York, NY, 2 of the first 3 centers to provide specialty training in laparoscopic and bariatric surgery in 1993.
Dr. Shouhed has written over 50 peer reviewed publications and book chapters, many related to bariatric surgery. His mastery of anatomy, metabolism, nutrition and physiology enable his patients to achieve the highest level of success long term in weight loss and overall health. He has performed countless revisional bariatric and foregut operations, which is why he knows how to perform each operation correctly the first time around. Most importantly, Dr. Shouhed considers every single one of his patients to be an extended part of his family and prides himself in maintaining a close relationship with each patient through lifelong follow-up.
Don’t just take it from us, hear what are patients are saying about Dr. Shouhed and their results.