The prevalence of morbidly obese individuals is rising rapidly. Being overweight predisposes patients to multiple serious medical comorbidities including type two diabetes, hypertension, dyslipidemia, and obstructive sleep apnea. This video shows step by step a totally robotic Roux-en-Y gastric bypass in an obese patient (BMI 42 kg/m 2 ). The patient was positioned supine with both legs in abduction. The robotic cart was placed above the patient's left shoulder and the first assistant was

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... oned between the patient's legs. A hand-sewn gastro-jejunal anastomosis and then a jejuno-jejunal anastomosis were performed. Small bowel was divided between the two anastomoses according to the technique of Olbers et al. [1] to obtain a 100-cm alimentary limb and a 60-cm biliopancreatic limb. No drain and no nasogastric tube were left in place at the end of operation. Reference [1] Olbers T, Fagevik-Olsén M, Maleckas A, Lönroth H. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity. Br J Surg 2005;92:557-62.