Robot-assisted laparoscopic Roux-en-Y gastric bypass

Original article

Abstract

Background

Robotic surgery promises to extend the capabilities of the minimally invasive surgeon. The aim of this study was to examine the feasibility of robotic surgery in the setting of laparoscopic gastric bypass.

Methods

The Zeus robotic surgical system was used in 50 laparoscopic gastric bypass procedures. The learning curve was staged to add complexity to the robotic tasks as experience grew. Robotic setup time, robotic operative time, total operative time, and operative outcomes were tracked prospectively.

Results

We observed a significant decrease in the robotic setup time. Our robotic learning curve demonstrated decreased operative time, even as more complex tasks were accomplished. Total operative time also decreased significantly over the series. There were no complications in our series that could be attributed to the robotic technique.

Conclusions

Robot-assisted laparoscopic Roux-en-Y gastric bypass is safe. The steadiness and extra degrees of freedom of surgical robotic systems may improve the accuracy of laparoscopic tasks. The learning curve for robot-assisted laparoscopic Roux-en-Y gastric bypass is significant but manageable.

Keywords

Zeus surgical robotic system Robotic surgery Roux-en-Y Gastric bypass Laparoscopy Telesurgery Obesity surgery 

References

  1. 1.
    Chang, L, Satava, RM, Pellegrini, CA, Sinanan, MN 2003Robotic surgery: identifying the learning curve through objective measurement of skillSurg Endosc1717441748CrossRefPubMedGoogle Scholar
  2. 2.
    DeMaria, EJ, Sugerman, HJ, Kellum, JM, Meador, JG, Wolfe, LG 2002Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesityAnn Surg235640647CrossRefPubMedGoogle Scholar
  3. 3.
    Hernandez, JD, Bann, SD, Munz, Y, Moorthy, K, Datta, V, Martin, S, Dosis, A,  et al. 2004Qualitative and quantitative analysis of the learning curve of a simulated surgical task on the da Vinci systemSurg Endos2.Google Scholar
  4. 4.
    Higa, KD, Ho, T, Boone, KB 2001Laparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-upJ Laparoendosc Adv Surg Tech11377382CrossRefGoogle Scholar
  5. 5.
    Lujan, JA, Frutos, MD, Hernandez, Q, Liron, R, Cuenca, JR, Valero, G, Parrilla, P 2004Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective studyAnn Surg239433437PubMedGoogle Scholar
  6. 6.
    Marescaux, J, Smith, MK, Folscher, D, Jamali, F, Malassagne, B, Leroy, J 2001Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patientsAnn Surg23417CrossRefPubMedGoogle Scholar
  7. 7.
    Nguyen, NT, Goldman, C, Rosenquist, CJ, Arango, A, Cole, CJ, Lee, SJ, Wolfe, BM 2001Laparoscopic versus open gastric, bypass: a randomized study of outcomes, quality of life, and costsAnn Surg234279289CrossRefPubMedGoogle Scholar
  8. 8.
    Nio, D, Balm, R, Maartense, S, Guijt, M, Bemelman, WA 2004The efficacy of robot-assisted versus conventional laparoscopic vascular anastomoses in an experimental modelEur J Vasc Endovasc Surg27283286CrossRefPubMedGoogle Scholar
  9. 9.
    Oliak, D, Ballantyne, GH, Weber, P, Wasielewski, A, Davies, RJ, Schmidt, HJ 2003Laparoscopic Roux-en-Y gastric bypass: defining the learning curveSurg Endosc17405408CrossRefPubMedGoogle Scholar
  10. 10.
    Pirisi, A 2003Telerobotics brings surgical skills to remote communitiesLancet36117941795CrossRefPubMedGoogle Scholar
  11. 11.
    Rolls, BJ 2003The supersizing of America: portion size and the obesity epidemicNutr Today384253CrossRefPubMedGoogle Scholar
  12. 12.
    Schauer, PR, Ikramuddin, S, Gourash, W, Ramanathan, R, Luketich, J 2000Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesityAnn Surg232515529CrossRefPubMedGoogle Scholar
  13. 13.
    Schauer, PR, Ikramuddin, S, Hamad, G, Gourash, W 2003The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 casesSurg Endosc17212215CrossRefPubMedGoogle Scholar
  14. 14.
    Talamini, MA, Chapman, S, Horgan, S, Melvin, WS 2003A prospective analysis of 211 robotic-assisted surgical proceduresSurg Endosc1715211524CrossRefPubMedGoogle Scholar
  15. 15.
    Wittgrove, AC, Clark, GW 1999Laparoscopic gastric bypass: a five-year prospective study of 500 patients followed from 3 to 60 monthsObes Surg9123143CrossRefPubMedGoogle Scholar
  16. 16.
    Wyatt, HR 2003The prevalence of obesityPrim Care30267279PubMedGoogle Scholar
  17. 17.
    Zimmermann-Belsing, T, Feldt-Rasmussen, U 2004Obesity: the new worldwide epidemic threat to general health and our complete lack of effective treatmentEndocrinology14515011502CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of California-DavisSacramentoUSA

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