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Obesity Surgery
Published in: Obesity Surgery 7/2015

01-07-2015 | Original Contributions

Risk Factors for Postoperative Morbidity After Totally Robotic Gastric Bypass in 302 Consecutive Patients

Authors: G. Fantola, P. L. Nguyen-Thi, N. Reibel, M. A. Sirveaux, A. Germain, A. Ayav, L. Bresler, R. Zarnegar, L. Brunaud

Published in: Obesity Surgery | Issue 7/2015

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Abstract

Background

Totally robotic gastric bypass (robotic Roux-en-Y gastric bypass, R-RYGBP) has been adopted in some centers on the basis of large retrospective studies. In view of some data showing higher morbidity and higher costs, some authors have considered that robotic gastric bypass may no longer be justified with the existing system. Although low postoperative complication rates after R-RYGBP have been reported, risk factors for postoperative morbidity have never been evaluated. The goal of this study was to identify risk factors for postoperative morbidity after R-RYGBP.

Methods

A retrospective analysis of a prospectively maintained database was performed and included 302 consecutive patients after R-RYGBP performed between 2007 and 2013. This subset of patients represented 34 % of all gastric bypass procedures performed during this study period. Univariate and multivariate analyses were performed in order to identify risk factors for postoperative overall morbidity (Clavien scores 1–4 versus 0) and major morbidity (Clavien score ≥3 versus 0–1–2).

Results

Postoperative morbidity and mortality rates were 24.4 and 0.6 %, respectively. In multivariate analysis, independent risk factors for overall morbidity were American Society of Anesthesiologists (ASA) score ≥3 (odds ratio (OR) 2.0) and previous bariatric surgery (revisional gastric bypass) (OR 2.0). Independent risk factors for major morbidity (Clavien ≥3) were previous bariatric surgery (revisional gastric bypass) (OR 3.7), low preoperative hematocrit level (OR 0.9), and revisional gastric bypass procedure with concomitant gastric banding removal (OR 5.7).

Conclusions

R-RYGBP is prone to increased complications in the setting of a high preoperative ASA score and revisional surgery. This should be taken into consideration by clinicians when evaluating R-RYGBP.
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Metadata
Title
Risk Factors for Postoperative Morbidity After Totally Robotic Gastric Bypass in 302 Consecutive Patients
Authors
G. Fantola
P. L. Nguyen-Thi
N. Reibel
M. A. Sirveaux
A. Germain
A. Ayav
L. Bresler
R. Zarnegar
L. Brunaud
Publication date
01-07-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1530-5

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