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Less Morbidity with Robot-Assisted Gastric Bypass Surgery than with Laparoscopic Surgery?

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Abstract

Introduction

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.

Results

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.

Conclusion

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.

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Acknowledgements

We thanks Dr Remi Houdart and Dr José Hobeika who performed many of the L-GB cases included in this study.

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Authors and Affiliations

  1. Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint-Simon, 125, rue d’Avron, 75020, Paris, France

    J. Cahais, R. M. Lupinacci, O. Oberlin, N. Goasguen & A. Valverde

  2. Research and Biostatistics Unit, Fondation Rothschild Hospital, Paris, France

    K. Zuber

Authors
  1. J. Cahais
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  2. R. M. Lupinacci
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  3. O. Oberlin
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  4. N. Goasguen
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  5. K. Zuber
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  6. A. Valverde
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Corresponding author

Correspondence to J. Cahais.

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Ethical Approval Statement

For this type of study, formal consent is not required.

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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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Cahais, J., Lupinacci, R.M., Oberlin, O. et al. Less Morbidity with Robot-Assisted Gastric Bypass Surgery than with Laparoscopic Surgery?. OBES SURG 29, 519–525 (2019). https://doi.org/10.1007/s11695-018-3545-9

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  • DOI: https://doi.org/10.1007/s11695-018-3545-9

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