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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NIH Conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115:956–61.CrossRefGoogle Scholar
Cohen RV, Pinheiro JC, Schiavon CA, Salles JE, Wajchenberg BL, Cummings DE. Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity. Diabetes Care. 2012;35:1420–8.CrossRefPubMedPubMedCentralGoogle Scholar
Bailey JG, Hayden JA, Davis PJ, Liu RY, Haardt D, Ellsmere J. Robotic versus laparoscopic Roux-en-Y gastric bypass (RYGB) in obese adults ages 18 to 65 years: a systematic review and economic analysis. Surg Endosc. 2014;28:414–26.CrossRefPubMedGoogle Scholar
Markar SR, Karthikesalingam AP, Venkat-Ramen V, Kinross J, Ziprin P. Robotic vs. laparoscopic Roux-en-Y gastric bypass in morbidly obese patients: systematic review and pooled analysis. Int J Med Robot. 2011;7:393–400.CrossRefPubMedGoogle Scholar