Woman first person in area to have robotic gastric sleeve procedure

Dr. Matthew Fourman, far right, and his team use the da Vinci Surgery system on his patient.

The Blade/Amy E. Voigt
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Jamie Barkimer, and her husband, Nate, listen as Dr. Matthew Fourman, right, and nurse Dawn Herr prepare Mrs. Barkimer for surgery.

Despite being obese, Jamie Barkimer has never let her weigh get in her way.

The 33-year-old Lyons, Ohio, woman adopted a can-do attitude, actively participating in hiking, camping, and canoeing trips with her family.

"The moment I let my weight get in my way would be the moment I got bigger," Mrs. Barkimer said. "If my husband can do it, I can do it. Sometimes it would hurt or it might take me a little longer, but I did it."

Mrs. Barkimer, who has struggled with her weight since high school, spent years trying to manage it, but after numerous failed attempts to slim down, she sought help.

"I've watched what I eat, hired trainers. I've worked out, but nothing was working," Mrs. Barkimer said. "After years of failed diets, I knew I needed a tool to help me."

Dr. Matthew Fourman, far right, and his team use the da Vinci Surgery system on his patient.

The tool she opted for was robotic surgery. On Sept. 19, Mrs. Barkimer became the first person in the region to undergo a robotic gastric sleeve procedure.

The surgery, which took place at Mercy St. Vincent Medical Center was performed with da Vinci Surgical Systems, one of the newest forms of minimally invasive surgery. The system allowed Dr. Matthew Fourman, medical director of bariatric surgery at St. Vincent, to control robotic arms that hold cameras and surgical instruments from a console near the operating table.

"I can see in three dimensions versus two," said Dr. Fourman, who is also the director of the Mercy Weight Management Center. "Laparoscopic tools open and close and rotate. The robot allows me to move 360 degrees."

The gastric sleeve is a restrictive procedure, reducing the volume of the stomach, which allows patients to feel full faster and with less food intake. Some of the benefits include quick weight loss, long-term weight loss success, and improvement in serious medical conditions such as asthma, type 2 diabetes, and high blood pressure. Candidates for the surgery must have a body mass index of at least 35 or suffer from serious medical conditions related to obesity that would improve with weight loss.

Mrs. Barkimer had 80 percent of her stomach removed with the sleeves. She's already lost more than 17 pounds and expects to lose 60 percent to 80 percent of her excess weight within two years. She declined to say what she weighed before the surgery or what she weighs now.

One of the biggest advantages of the robotic procedure is decreased post-operative pain and an easier recovery, Dr. Fourman said. Before the robotic procedure, patients could opt for the traditional approach, which involves a large incision in the abdomen, is more painful for the patient and requires longer recovery time. The laparoscopic approach is also minimally invasive and requires the use of instruments to go through walls in the body, Dr. Fourman said.

"We see a big difference between incision and laparoscopic procedures," Dr. Fourman said. "Even more so, there is a difference between laparoscopic and the robotic approach."

Risks with the robotic procedure include bleeding, infection, damage to other structures, and leaks from the incision.

For Mrs. Barkimer, an office manager, the robotic approach "just best fit my lifestyle." She spent one night in the hospital after the surgery and walked away with an incision just two centimeters long.

"I was virtually pain free," she said. "I was up and moving around almost right away. I had some discomfort, but it was tolerable. I was turning down pain medication."

Outcomes vary by patient and the robotic procedure may not be the best approach for all patients, Dr. Fourman said.

While the surgery will automatically lead to some weight loss, healthy eating and exercise are keys for patients to achieve the maximum benefits.

"The sleeve limits the amount of food a patient can eat, but education on exercise, how to eat and what to eat, is very important," Dr. Fourman said. "With the sleeve, you focus on [eating] the healthy foods because there just isn't enough room for the junk."

Mrs. Barkimer will continue to work with Dr. Fourman and his staff to ensure she reaches her weight goals, which she hopes will lead to her dream of having a children.

"I've suffered a lot infertility problems because of my weight," Mrs. Barkimer said. "Knowing that I want to have children, I think this is a step in the right direction."

Contact RoNeisha Mullen at rmullen@theblade.com or 419-724-6133.