Section: News

Flagler Hospital Surgeon First in Florida to Perform Innovative Surgery

Flagler Hospital Surgeon First in Florida to Perform Innovative Surgery

SAINT AUGUSTINE, FL (July 21, 2010) – Dr. Robert Marema, one of the nation’s most recognized experts on surgical weight loss, is now the first surgeon in Florida and second in the world to perform a single–incision vertical sleeve gastrectomy using the SPIDER® Surgical System.

Vertical sleeve gastrectomy is the latest and fastest growing type of surgical weight loss procedure, which dramatically minimizes the size of a patient’s stomach. Without using SPIDER, surgeons typically rely on conventional laparoscopic equipment that requires five separate small incisions in a patient’s abdomen – rather than just one.

“The SPIDER minimizes physical stress on patients while also providing cosmetic benefits,” commented Marema. “I simply make one small incision that’s hidden in the patient’s belly button and insert the SPIDER. I then expand the internal portion of the device, similar to expanding an umbrella. This allows me to clearly see the anatomy and accurately perform the operation. When I’m finished, I close the system and remove it through the small incision, leaving almost no visible scar.”

This marks the first time the SPIDER Surgical System has been used to perform this procedure in Florida. Released on a limited basis beginning in March, SPIDER has been used by surgeons to perform other procedures including colon re–sections, kidney and gallbladder removals, and gastric banding.

SPIDER’s proprietary expansion technology is unique – it is not available in any other surgical device today. In addition, SPIDER contains four working channels through which the surgeon inserts a camera and instruments. Two of the channels are flexible, providing surgeons with true left and true right instrumentation, a marked contrast to other single–port instruments that force a surgeon to cross his hands to operate.

“As an individual who has been involved with the evolution of bariatric surgery since its earliest beginnings, I am continuously seeking new ways to improve the experience and outcomes for my patients,” added Marema. “The SPIDER definitely provides several advantages that I am happy to offer as part of our program.”  

Marema is the medical director at the Flagler Hospital Bariatric Surgery Center – a Center of Excellence facility located in St. Augustine, Florida. He has performed more than 12,000 bariatric procedures, is a long–standing member of the American Society for Metabolic and Bariatric Surgery, Fellow of the American College of Surgery, Diplomat of the American Board of Surgery and a member of the American Medical Association.

TransEnterix, a fast–growing medical device company, created the SPIDER Surgical System. TransEnterix partners with leading medical thought-leaders to rapidly develop pioneering technologies that advance minimally invasive surgery. For more information, visit


About Flagler Hospital

Flagler Hospital is a 316-bed acute care hospital that is consistently recognized nationally for overall clinical excellence.  HealthGrades has ranked Flagler Hospital among the top 5% of all hospitals in the nation for the past 6 consecutive years. They also named Flagler Hospital as the #1 hospital in the state of Florida for general surgery outcomes in 2009 and 2010. Most recently, the hospital earned accreditation from the Society of Chest Pain Centers.  It also has the Gold Seal of Approval™ from The Joint Commission for Primary Stroke Care Centers and Center of Excellence Designation for its Bariatric Surgery Center. For more information about Flagler Hospital, please visit us at