100 Robotic-Assisted Laparoscopic Gastric Bypasses at a Community Hospital

Deng, Janice Jianhong; Lourie, David

doi:10.1177/000313480807401030

Cited by 29 publications

(8 citation statements)

References 9 publications

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“…For the robotic series, most authors have noted a significant and rapid learning curve. Deng and Lourie [15] described a mean operative time of 200 min for their first 30 cases versus 184 min for the second 30 ( P = 0.03). Likewise, Hubens et al [13] reported that the total operative time decreased from 231 to 136 min ( P < 0.05) after the first 35 cases.…”

Section: Discussionmentioning

confidence: 99%

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Robot‐assisted versus Laparoscopic Roux‐en‐Y Gastric Bypass: Is There a Difference in Outcomes?

et al. 2010

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Background Application of the robot for Roux-en-Y gastric bypass has been slow to evolve, despite its rapid acceptance in other fields. This is largely due to associated costs of technology, reports of increased operative time, and inadequate data available to correlate the benefits of robotics to a clinical outcome. The authors present a comparative study between laparoscopic and robot-assisted Roux-en-Y gastric bypass performed at a specialized institution for robotic surgery. Materials and method A total of 135 consecutive Rouxen-Y gastric bypass procedures were performed from January 2006 to December 2009 by a single surgeon. The first 45 were performed laparoscopically and the remaining 90 were robot-assisted. Patient demographics, operative time, complication rate, length of stay, long-term weight loss, and follow-up for the two groups were gathered from a prospectively maintained database and statistically analyzed. Results The overall operative time was significantly shorter for the robot-assisted procedures than for the laparoscopic procedures (207 ± 31 vs. 227 ± 31 min) (P = 0.0006). The robotic set-up time remained constant at 13 ± 4 min. 30 robotic cases were necessary in order to perform the procedure in less time than with the laparoscopic approach (P = 0.047). Mortality was 0% in both groups, with no conversions to open surgery and no transfusions. Early morbidities and percentage of excess weight loss at 1 year were comparable for the two groups. Conclusions The use of the robot for performing the gastrojejunostomy during laparoscopic Roux-en-Y gastric bypass does not increase the operative time or the rate of specific complications. The short-term outcomes of the robot-assisted procedure are comparable to those found with the conventional laparoscopic method.

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Section: Discussionmentioning

confidence: 99%

“…The gastrointestinal leak rate for the robotic gastric bypass reported in the literature varies from 0 to 3% (Table 3) [3–15]. Earlier experiences by Moser and Horgan [3] demonstrated a 0% leak rate and 1% stricture rate, well below the reported rates for traditional laparoscopic gastric bypass.…”

Section: Discussionmentioning

confidence: 99%

Robot‐assisted versus Laparoscopic Roux‐en‐Y Gastric Bypass: Is There a Difference in Outcomes?

et al. 2010

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“…Minimally invasive surgery is being incorporated into general surgical practice. During the last decade, the advent of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) has enabled many complex procedures to be performed with minimally invasive techniques in bariatric surgery [ 3 ]. Roux en Y gastric bypass remains one of the most challenging procedures performed by bariatric and general surgeons [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Initial Learning Curve for Robot-Assisted Sleeve Gastrectomy: A Surgeon’s Experience While Introducing the Robotic Technology in a Bariatric Surgery Department

Vilallonga

Fort

González

et al. 2012

Minimally Invasive Surgery

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Objective. Robot-assisted sleeve gastrectomy has the potential to treat patients with obesity and its comorbidities. To evaluate the learning curve for this procedure before undergoing Roux en-Y gastric bypass is the objective of this paper. Materials and Methods. Robot-assisted sleeve gastrectomy was attempted in 32 consecutive patients. A survey was performed in order to identify performance variables during completion of the learning curve. Total operative time (OT), docking time (DT), complications, and length of hospital stay were compared among patients divided into two cohorts according to the surgical experience. Scattergrams and continuous curves were plotted to develop a robotic sleeve gastrectomy learning curve. Results. Overall OT time decreased from 89.8 minutes in cohort 1 to 70.1 minutes in cohort 2, with less than 5% change in OT after case 19. Time from incision to docking decreased from 9.5 minutes in cohort 1 to 7.6 minutes in cohort 2. The time required to dock the robotic system also decreased. The complication rate was the same in the two cohorts. Conclusion. Our survey indicates that technique and outcomes for robot-assisted sleeve gastrectomy gradually improve with experience. We found that the learning curve for performing a sleeve gastrectomy using the da Vinci system is completed after about 20 cases.

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“…– Bariatric outcome (postoperative Body Mass Index): only few trials reported the reduced mean BMI after 3 months from the RYGB [ 7 , 8 , 18 , 24 , 27 , 28 ] and SG [ 20 ] (Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

Current status of robotic bariatric surgery: a systematic review

et al. 2013

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BackgroundBariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review.MethodsA search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science.ResultsTwenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days).ConclusionsThe major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy).

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100 Robotic-Assisted Laparoscopic Gastric Bypasses at a Community Hospital

Cited by 29 publications

References 9 publications

Robot‐assisted versus Laparoscopic Roux‐en‐Y Gastric Bypass: Is There a Difference in Outcomes?

Robot‐assisted versus Laparoscopic Roux‐en‐Y Gastric Bypass: Is There a Difference in Outcomes?

The Initial Learning Curve for Robot-Assisted Sleeve Gastrectomy: A Surgeon’s Experience While Introducing the Robotic Technology in a Bariatric Surgery Department

Current status of robotic bariatric surgery: a systematic review

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