Robotic gastric bypass is getting better: first results from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program

Lundberg, Peter W.; Wolfe, Samantha; Seaone, Jacqueline; Stoltzfus, Jill; Claros, Leonardo; Chaar, Maher El

doi:10.1016/j.soard.2018.05.022

Cited by 32 publications

(7 citation statements)

References 23 publications

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“…The operation times for RRYGB were significantly shorter than LRYGB, despite inclusion of the first procedures using the da Vinci Xi system. In contrast to our data, most studies report a longer operative time when using the robot [11,15,16,[21][22][23]29]. However, the operative time varies considerably between these publications, decreasing from a high of 245 min [13] to 108 min [16].…”

Section: Discussioncontrasting

confidence: 99%

“…Meta-analyses have confirmed the lower incidence of complications, longer surgery times, and higher costs associated with RRYGB but criticized the relatively low quality of the existing studies and the lack of large randomized controlled trials [21,22]. US registry data indicate the increasing prevalence of RRYGB, which comprised 5.8% (n = 2282) of all RYGB procedures in 2016 (versus 39,425 LRYGB procedures), with comparable complication rates but longer surgery time (138 min) versus LRYGB (108 min) [23]. Despite the increase, it remains controversial whether the use of the robot in bariatric surgery is justified.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

et al. 2020

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Background Proximal Roux-en-Y gastric bypass is commonly used to manage obesity, performed using laparoscopic or robotassisted minimally invasive surgery. As the prevalence of robotic bariatric surgery increases, further data is required to justify its use. Methods This was a large, retrospective analysis of prospectively recorded data for Roux-en-Y gastric bypass (RYGB) procedures performed using laparoscopic (LRYGB) or robotic (RRYGB; da Vinci Xi system, Intuitive Surgical Sàrl) surgery between January 2016 and March 2019. The surgical techniques did not differ apart from different trocar placements. Data collected included patient characteristics before and after RYGB, operative outcomes and complications. Results In total, 114 RRYGB and 108 LRYGB primary surgeries were performed. There were no significant differences between the groups, apart from a significantly shorter duration of surgery (116.9 vs. 128.9 min, respectively), lower C-reactive protein values at days 1 (31.1 vs. 44.1 mg/l) and 2 (50.3 vs. 77.8 mg/l) after the intervention, and overall complication rate (4.4 vs. 12.0%, Clavien-Dindo classification II-V) with RRYGB compared with LRYGB. There was a lower hemoglobin value in the postoperative course after RRYGB (12.1 vs. 12.6 g/dl, day 2). Conclusions In our experience, robotic RYGB has proven to be safe and efficient, with a shorter duration of surgery and lower rate of complications than laparoscopic RYGB. RRYGB is easier to learn and seems safer in less experienced centers. Increasing experience with the robotic system can reduce the duration of surgery over time. Further studies with higher evidence level are necessary to confirm our results.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

et al. 2020

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“…This was a large study spanning 5 years using a bariatric-specific database that included many robotic patients (N 5 2415). More recently, our group showed a similar rate of SAE when comparing robotic and laparoscopic RYGB patients based on the more recent 2016 MBSAQIP data file [19]. Similarly, using 2015 to 2016 MBSAQIP data, Sebastian et al [16] demonstrated decreased length of stay, anastomotic leak, and renal complications for robotic RYGB patients after accounting for operative time and conversion rate.…”

Section: Discussionsupporting

confidence: 55%

Outcomes of robotic bariatric surgery in super-obese patients: first report based on MBSAQIP database

Pastrana

Stoltzfus

Claros

et al. 2020

Surgery for Obesity and Related Diseases

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“…While performing RSG, the disadvantages may outweigh the advantages [6][7][8]. The robot seems to be advantageous in primary RYGB regarding postoperative complications [17,18], but at the expense of higher costs and longer operative times [19]. Revision interventions are considered more complex and complicated [34], and the potential advantages of the robot system are likely to become more apparent.…”

Section: Discussionmentioning

confidence: 99%

“…There are slight advantages in terms of complications, burdened by a longer operative time and higher costs. Differing results from meta-analyses and register studies could result from publication bias and negative effects of the learning curve [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Pros and Cons of Robotic Revisional Bariatric Surgery

Beckmann¹,

Mehdorn²,

Kersebaum³

et al. 2020

Visc Med

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Introduction: Revisional procedures in bariatric surgery are regarded as technically more demanding and riskier than primary interventions. While the use of the surgical robot has not yet proven to be advantageous in primary bariatric interventions, the question remains whether its use is justified for more complex revisional procedures. Objective: To show that revisional bariatric surgery can be performed safely using the da Vinci® Xi surgical system. Methods: We performed a retrospective analysis of prospectively recorded data for revisional bariatric procedures between January 2016 and November 2019. Results: Of 78 revision operations, four (5.1%) were performed by open surgery, 30 (38.5%) by laparoscopic surgery, and 44 (56.4%) by robotic surgery. A comparative analysis of robotic (n = 41) versus laparoscopic (n = 18) revisional Roux-en-Y gastric bypasses (rRYGB) revealed significant differences favoring the robotic approach for operative time (130.7 vs. 167.6 min), C-reactive protein values at days 1 (27.9 vs. 49.1 mg/L) and 2 (48.2 vs. 83.6 mg/L) after surgery, and length of stay (4.9 vs. 6.2 days). Lower complication rates (Clavien-Dindo II–V) were found after rRRYGB (7.3 vs. 22.2%, not significant). Conclusions: Revisional bariatric surgery using a robotic system is safe. The operative time performing rRRYGB is significantly shorter than rLRYGB in our experience. Otherwise, results were largely comparable. Due to different indications, different index operations and a wide range of revisional procedures, further studies are necessary to confirm these results.

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Robotic gastric bypass is getting better: first results from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program

Cited by 32 publications

References 23 publications

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

Outcomes of robotic bariatric surgery in super-obese patients: first report based on MBSAQIP database

Pros and Cons of Robotic Revisional Bariatric Surgery

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