Technique Evolution, Learning Curve, and Outcomes of 200 Robot-assisted Gastric Bypass Procedures: a 5-year Experience

Overview

Journal Obes Surg

Date 2014 Nov 15

PMID 25394589

Citations 9

Authors

Vivek Bindal

Raquel Gonzalez-Heredia

Mario Masrur

Enrique F Elli

Affiliations

Soon will be listed here.

Abstract

Background: We evaluate our 5-year experience, evolution of technique, and clinical outcomes with robot-assisted RYGB.

Methods: Two hundred consecutive patients who underwent robot-assisted RYGB at our center were included. Among them, 118 patients underwent a hybrid robot-assisted laparoscopic RYGB (LRRYGB), and 82 patients underwent a totally robotic RYGB (TRRYGB). Patient demographics, clinical characteristics, comorbidities, operative parameters, conversions, morbidity, mortality, and excess weight loss were analyzed.

Results: Most of the patients (88 %) were female with a mean age of 41.9 years and mean BMI of 46.6 kg/m(2). The outcomes of patients who underwent LRRYGB (n = 118) were compared to those who underwent TRRYGB (n = 82). The mean operative time in TRRYGB group was 170.9 ± 51.4 min which was significantly lower than LRRYGB group (216 ± 54.1 min). The mean operative time for the last 100 patients was significantly lower than that for the first 100 patients. The excess weight loss (EWL) was 58.3 % at 6 months, 67.7 % at 1 year, 71.6 % at 2 years, and 65 % at 3 years. There were three conversions to open, three reoperations and four readmissions. There were no anastomotic leak, major bleed, gastrojejunostomy stricture, or mortality seen in our series.

Conclusions: Use of robot assistance to perform RYGB is safe and may reduce the associated complications, namely, anastomotic leak, gastrojejunostomy (GJ) stricture, and hemorrhage. Excess weight loss at 2 years after RRYGB is comparable to laparoscopic RYGB.

Citing Articles

A Systematic Review to Summarise and Appraise the Reporting of Surgical Innovation: a Case Study in Robotic Roux-en-Y Gastric Bypass.

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Robotic Roux-en-Y Gastric Bypass: A Single Surgeon's Experience with 527 Consecutive Patients.

Bedirli A, Yavuz A, Dikmen K, Buyukkasap C, Ozaydin S JSLS. 2022; 26(1).

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Systematic review of learning curves in robot-assisted surgery.

Soomro N, Hashimoto D, Porteous A, Ridley C, Marsh W, Ditto R BJS Open. 2020; 4(1):27-44.

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Factors Associated with Weight Loss After Metabolic Surgery in a Multiethnic Sample of 1012 Patients.

Masrur M, Bustos R, Sanchez-Johnsen L, Gonzalez-Ciccarelli L, Mangano A, Gonzalez-Heredia R Obes Surg. 2019; 30(3):975-981.

PMID: 31848986 DOI: 10.1007/s11695-019-04338-w.

Robotic-Assisted Roux-en-Y Gastric Bypass: Learning Curve Assessment Using Cumulative Sum and Literature Review.

Bustos R, Mangano A, Gheza F, Chen L, Aguiluz-Cornejo G, Gangemi A Bariatr Surg Pract Patient Care. 2019; 14(3):95-101.

PMID: 31572625 PMC: 6763956. DOI: 10.1089/bari.2018.0042.

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