Indications for the Roux-en-Y gastric bypass (RYGB) remain the same as they have been since the 1991 publication of the NIH Consensus Guidelines: BMI ≥ 40 or BMI 35–39 with one or more obesity-related comorbidities . There are data, however, that support the benefits and safety of the RYGB in patients with a lower BMI with metabolic burden, particularly diabetes, suggesting that these indications should be reconsidered . In reviews of comparative studies looking at robotic versus laparoscopic approaches to the RYGB, two trends seem to consistently stand out: (1) major complications, particularly leaks, tend to be lower in the robotic groups; and (2) the operative times tend to be longer in the robotic groups . The longer operative times should be a consideration in terms of minimizing added risks to the patient and minimizing impact on productivity; the operative times can be considerably longer. In transitioning to a robotic approach to the RYGB, the intention should be to progress to performing all RYGBs robotically, so the indications for a robotic RYGB should be the same as for RYGB in general.
Roux-en-Y gastric bypass RYGB Bariatric surgery
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