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

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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/m2. 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.

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Conflict of Interest

Vivek Bindal declares no conflict of interest

Raquel Gonzalez-Heredia declares no conflict of interest

Mario Masrur declares no conflict of interest

Enrique F. Elli declares no conflict of interest

Statement of Informed Consent

Informed consent for surgery was obtained from all individual participants included in the study before they underwent the procedure. As this is a retrospective analysis, formal consent is not required and an exempt application was approved by the Institutional Review Board.

Statement of Human Rights

For this type of retrospective study, formal consent is not required and an exempt application was approved by the Institutional Review Board.

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Authors and Affiliations

  1. Division of General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, 840 S Wood St, Suite 435E, M/C 958, Chicago, IL, 60612, USA

    Vivek Bindal, Raquel Gonzalez-Heredia, Mario Masrur & Enrique F. Elli

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  1. Vivek Bindal
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  2. Raquel Gonzalez-Heredia
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Correspondence to Vivek Bindal.

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Bindal, V., Gonzalez-Heredia, R., Masrur, M. et al. Technique Evolution, Learning Curve, and Outcomes of 200 Robot-Assisted Gastric Bypass Procedures: a 5-Year Experience. OBES SURG 25, 997–1002 (2015). https://doi.org/10.1007/s11695-014-1502-9

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  • DOI: https://doi.org/10.1007/s11695-014-1502-9

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