Anastomotic leak test using indocyanine green during laparoscopic Roux-en-Y gastric bypass: A cohort study

Pavone, Giovanna; Fersini, Alberto; Pacilli, Mario; Cianci, Pasquale; Ambrosi, Antonio; Tartaglia, Nicola

doi:10.1016/j.amsu.2022.104939

Cited by 6 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with endoscopic or laparoscopic techniques, robotic surgical systems suffer from a complete loss of tactile feedback to the user ( 26 ). Consequently, surgeons rely on visual cues and their expertise in order to perform the accurate motor movements required for operations ( 27 , 28 ). The absence of tactile feedback leads to prolonged procedural times and a greater risk of surgical error ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can robotic gastric bypass be considered a valid alternative to laparoscopy? Our early experience and literature review

Pavone,

Pacilli,

Gerundo

et al. 2024

Front. Surg.

Self Cite

View full text Add to dashboard Cite

BackgroundRobotic bariatric surgery serves as an alternative to laparoscopy. The technology provides the surgeon with an accurate three-dimensional view, allowing complex maneuvers while maintaining full control of the operating room.HypothesisWe report our experience with this innovative surgery compared with laparoscopy during Roux-en-Y gastric bypass to demonstrate its safety and feasibility. The aim of this study is to evaluate potential differences between the robotic and laparoscopic techniques.Materials and methodsOur study retrospectively identified 153 consecutive obese patients who underwent either laparoscopic or robotic gastric bypass (RGB) procedures over a 2-year period at the Department of Medical and Surgical Sciences, University of Foggia. Data on demographics, operative time, conversion rate, length of hospital stay, and mortality were collected and compared between two groups of patients: 82 patients who underwent laparoscopic procedures and 71 who underwent robotic procedures.ResultsWe analyzed 153 patients who underwent gastric bypass with a mean age of 42.58 years, of whom 74 were female; 71 were treated with a robotic approach and 82 with a laparoscopic approach. The mean operative time was 224.75 ± 10.4 min for RGB (including docking time) and 101.22 min for laparoscopic gastric bypass (LGB) (p < 0.05), which is statistically significant. The median length of stay was 4.1 days for the RGB group and 3.9 days for the LGB group (p = 0.89). There is only one conversion to laparoscopy in the RGB group. We observed only one case of postoperative complications, specifically one episode of endoluminal bleeding in the laparoscopic group, which was successfully managed with medical treatment. No mortality was observed in either group.ConclusionThe statistical analysis shows to support the robotic approach that had a lower incidence of complications but a longer operative duration. Based on our experience, the laparoscopic approach remains a technique with more haptic feedback than the robotic approach, making surgeons feel more confident.This study has been registered on ClinicalTrial.gov Protocol Registration and Results System with this ID: NCT05746936 for the Organization UFoggia (https://clinicaltrials.gov/ct2/show/NCT05746936).

show abstract

Section: Discussionmentioning

confidence: 99%

“…the user (26). Consequently, surgeons rely on visual cues and their expertise in order to perform the accurate motor movements required for operations (27,28). The absence of tactile feedback leads to prolonged procedural times and a greater risk of surgical error (29).…”

Section: Discussionmentioning

confidence: 99%

Can robotic gastric bypass be considered a valid alternative to laparoscopy? Our early experience and literature review

Pavone,

Pacilli,

Gerundo

et al. 2024

Front. Surg.

Self Cite

View full text Add to dashboard Cite

show abstract

“…It should be also noted that, thus far, indocyanine green (ICG) angiography is not supported by the Hugo™ RAS system. ICG angiography can be useful in cases of doubtful perfusion of the gastric pouch and anastomoses, especially in revisional surgery, where the technical advantages of the robotic platform can be decisive, but thus far the Hugo™ RAS system does not support it, which is a temporary limitation of the platform ( 32 – 34 ). Another limitation of the Hugo™ platform is the lack of robotic staplers that would allow to complete a totally robotic procedure.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS

et al. 2023

View full text Add to dashboard Cite

IntroductionRobotic assisted surgery is a rapidly developing field of minimally invasive bariatric surgery in the last 20 years. Its wide diffusion has led to the development and standardization of robotic assisted approaches for bariatric operations. In this study, we present the first four Roux-en-Y Gastric Bypass (RYGB) operations performed with the new Hugo™ RAS system (Medtronic, Minneapolis, MN, USA).MethodsIn January and February 2023, 4 consecutive patients scheduled for minimal invasive Roux-en-Y-Bypass were selected and underwent the procedure robotic-assisted with the new platform. No exclusion criteria were applied.ResultsFour patients, two females and two males, underwent RYGB with a median BMI of 40 Kg/m2 (range: 36–46) and diabetes mellitus in two cases. The median docking time was 8 min (range: 7–8.5) and the median console time was 127.5 min (range: 95–150). A description of the operating theatre, robotic arms and docking setup is provided. Procedures were performed without intraoperative complications and no conversion to laparoscopy or open surgery was noted. No additional ports were needed to be placed. System's function and docking were uneventful. No early post-operative complications were observed.ConclusionsBased on our initial experience, RYGB with the Hugo™ RAS system is feasible. This study provides the configurations necessary to perform RYGB with the Hugo™ RAS system as well as general information and insights from our preliminary experience.

show abstract

Staple Line and Anastomotic Leaks

Lee,

Spaniolas

2024

The SAGES Manual of Metabolic and Bariatric Surgery

View full text Add to dashboard Cite

Anastomotic leak test using indocyanine green during laparoscopic Roux-en-Y gastric bypass: A cohort study

Cited by 6 publications

References 30 publications

Can robotic gastric bypass be considered a valid alternative to laparoscopy? Our early experience and literature review

Can robotic gastric bypass be considered a valid alternative to laparoscopy? Our early experience and literature review

Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS

Staple Line and Anastomotic Leaks

Contact Info

Product

Resources

About