Less Morbidity with Robot-Assisted Gastric Bypass Surgery than with Laparoscopic Surgery?
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Although several studies have compared totally robot-assisted gastric bypass (RA-GB) to laparoscopic gastric bypass (L-GB), the clinical benefit of the robotic approach remains unclear.
Materials and Methods
We compared perioperative outcomes of 82 consecutive patients undergoing RA-GB between 2013 and 2016 to 169 consecutive patients having undergone L-GB between 2009 and 2016. Secondary endpoints included duration of hospitalization, readmission rate, weight loss at 1 year, and the learning curve of RA-GB, assessed by operation times and complication rates.
There were no statistically significant differences between groups concerning age (43.5 ± 11.2 vs. 42.2 ± 12.4 years), body mass index (42.4 ± 5.0 vs. 43.6 ± 7.2 kg/m2), or comorbidities. The rate of revision surgery was higher in L-GB group without reaching statistical significance. No statistically significant difference was observed for duration of operation (134 ± 35 vs. 135 ± 37 min), readmission rate at 90 days (4.9% vs. 8.9%), or percentage of excess weight loss at 1 year (RA-GB vs. L-GB) (76.8% ± 20.5 vs. 73.1% ± 23.5). There were fewer statistically significant complications overall in RA-GB (9.8% vs. 21.9%, p = 0.019). Median duration of hospital stay was shorter for RA-GB (3 vs. 4 days, p < 0.0001). The mean duration of operation for RA-GB decreased from 153 min in 2014 to 122 min in 2016; p = 0.004.
In our experience, the robotic approach for gastric bypass was associated with fewer postoperative complications compared to traditional laparoscopic gastric bypass. Cost increment associated with RA-GB remains an important drawback that hampers its widespread.
KeywordsGastric bypass Robot-assisted surgery Manual anastomosis Minimal access surgery
We thanks Dr Remi Houdart and Dr José Hobeika who performed many of the L-GB cases included in this study.
Compliance with Ethical Standards
Ethical Approval Statement
For this type of study, formal consent is not required.
Informed Consent Statement
Does not apply.
Conflict of Interest
Disclosure Author 6, Author 3, and Author 4 are proctors for Intuitive Surgical and Covidien. Author 1 and Author 2 have no conflicts of interest or financial ties to disclose.
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