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Comparative analysis of robotic versus laparoscopic Roux-en-Y gastric bypass in severely obese patients

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Abstract

Benefits of robotic surgery for Roux-en-Y gastric bypass (RYGB) are still debated. We aimed to compare conventional laparoscopic (L-RYGB) to robotic RYGB (R-RYGB) and evaluate safety, efficacy, advantages and drawbacks of each procedure. A prospective cohort study with a retrospective review approach was conducted to analyze results of L-RYGB and R-RYGB performed at a bariatric center of excellence. Patient demographics, perioperative data, weight loss, comorbidities evolution and cost were assessed. One hundred and sixty-one severely obese patients underwent R-RYGB and L-RYGB, respectively. Patient’s characteristics were similar between groups. Intraoperative blood loss was similar (p = 0.91), with no requirement for blood transfusion. Median operative time was significantly reduced for R-RYGB (127 vs 160 min; p < 0.001). Seven patients (11.4%) in the L-RYGB group and 15 patients (15%) in the R-RYGB group had early postoperative complications (p = 0.63), with more anastomotic leaks and stenosis for R-RYGB during initial learning curve (p = NS). Mortality was null. Median length of hospital stay was similar (6 days; p = 0.20). Mean hospital cost was non-significantly increased for R-RYGB ($5730 vs. $4879; p = 0.34). Two years after surgery, median BMI and mean EWL% were similar for both groups (26.1 vs 26.5 kg/m2 and 89.9% vs 90.9% for L-RYGB and R-RYGB groups, respectively; p = 0.71 and 0.85, respectively), with no statistically significant difference in comorbidities between the two groups (p = 0.80). R-RYGB is feasible and safe within the reach of every laparoscopic surgeon. In our series, it was associated with shorter operative time and equivalent length of stay and weight loss outcomes compared to L-RYGB. Further well-designed randomized studies are necessary to draw safe conclusions.

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The datasets of the current study can be provided by the corresponding author on reasonable request.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, Assistance Publique–Hôpitaux de Paris, 157 rue de la Porte de Trivaux, 92141, Clamart cedex, France

    Panagiotis Lainas, Joseph Derienne & Ibrahim Dagher

  2. Paris-Saclay University, 91405, Orsay, France

    Panagiotis Lainas & Ibrahim Dagher

  3. Department of Digestive and Bariatric Surgery, CHU Felix-Guyon, Saint-Denis, La Reunion, France

    Radwan Kassir

  4. Department of Digestive Surgery, Archet II Hospital, Nice, France

    Marine Benois, Tarek Debs, Jean Gugenheim & Imed Ben Amor

  5. University of Nice-Sophia-Antipolis, Nice, France

    Marine Benois, Tarek Debs, Jean Gugenheim & Imed Ben Amor

  6. Methodological Support Unit, INSERM, CIC1410, CHU Felix-Guyon, Saint-Denis, La Reunion, France

    Maissa Safieddine

Authors
  1. Panagiotis Lainas
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  2. Radwan Kassir
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  3. Marine Benois
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  4. Joseph Derienne
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  7. Jean Gugenheim
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  8. Ibrahim Dagher
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  9. Imed Ben Amor
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Contributions

PL and IBA contributed to the study conception and design. Material preparation, data collection and analysis were performed by MB and TD. The first draft of the manuscript was written by PL, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Panagiotis Lainas.

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Conflict of interest

Panagiotis Lainas, Radwan Kassir, Marine Benois, Joseph Derienne, Tarek Debs, Maissa Safieddine, Jean Gugenheim, Ibrahim Dagher, and Imed Ben Amor declare to have no conflicts of interest or financial ties to disclose.

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Lainas, P., Kassir, R., Benois, M. et al. Comparative analysis of robotic versus laparoscopic Roux-en-Y gastric bypass in severely obese patients. J Robotic Surg 15, 891–898 (2021). https://doi.org/10.1007/s11701-020-01181-5

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  • DOI: https://doi.org/10.1007/s11701-020-01181-5

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