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Published in: Obesity Surgery 6/2016

01-06-2016 | Original Contributions

The Results of 100 Robotic Versus 100 Laparoscopic Gastric Bypass Procedures: a Single High Volume Centre Experience

Authors: R. M. Smeenk, G. van ‘t Hof, E. Elsten, P. G. B. M. Feskens

Published in: Obesity Surgery | Issue 6/2016

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Abstract

Background

The introduction of robotics in bariatric surgery is a novel development since the beginning of this century. The aim of this study is to compare surgical outcome of the robotic gastric bypass with the laparoscopic counterpart.

Methods

A retrospective study was conducted to compare the results of 100 fully robotic gastric bypasses (RGB) and 100 laparoscopic gastric bypasses (LGB) performed by a single surgeon. Surgical outcome was analysed by evaluating operation room time and surgical time, morbidity and mortality, and length of hospital stay.

Results

In the RGB and LGB group, respectively, 92 and 80 % of operated patients were female (p = 0.024). Mean age was 39 (range 20–62, SD 10.21) and 42 years (range 18–65, SD 11.87), respectively (p = 0.158). Mean BMI was 40 (range 35–47, SD 2.66) and 42 (range 35–56, SD 4.75), respectively (p < 0.05). Mean surgical time was 67 (range 39–210, SD 22.46) and 31 min (range 18–62, SD 9.12), respectively (p < 0.05). Mean operation room time was 117 (range 80–257, SD 30.13) and 66 min (range 38–101, SD 12.68), respectively (p < 0.05). The surgery-related 30-day morbidity rate was 5 % in both groups. Major morbidity (Clavien-Dindo class 3–4) was 3 and 1 %, respectively (p = 0.62). There was no mortality. Median hospital stay was two postoperative days in both groups. A learning curve developed after 25 procedures.

Conclusions

The RGB is a feasible procedure. Although more time is needed, a standardized technique results in fair operation times in the hands of an experienced surgeon.
Literature
1.
go back to reference Mason E, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47:1345–54.PubMed Mason E, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47:1345–54.PubMed
2.
go back to reference Wittgrove A, Clark G, Tremblay L. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:353–7.CrossRefPubMed Wittgrove A, Clark G, Tremblay L. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:353–7.CrossRefPubMed
3.
go back to reference Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11(6):415–9.CrossRefPubMed Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11(6):415–9.CrossRefPubMed
4.
go back to reference Talamini M, Chapman S, Horgan S, et al. A prospective analysis of 211 robotic-assisted surgical procedures. Academic Robotics Group. Surg Endosc. 2003;17(10):1521–4.CrossRefPubMed Talamini M, Chapman S, Horgan S, et al. A prospective analysis of 211 robotic-assisted surgical procedures. Academic Robotics Group. Surg Endosc. 2003;17(10):1521–4.CrossRefPubMed
5.
go back to reference Fourman M, Saber A. Robotic bariatric surgery: a systematic review. Surg Obes Relat Dis. 2012;8(4):483–8.CrossRefPubMed Fourman M, Saber A. Robotic bariatric surgery: a systematic review. Surg Obes Relat Dis. 2012;8(4):483–8.CrossRefPubMed
7.
go back to reference Dindo D, Demartines N, Clavien P. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien P. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral
8.
go back to reference NIH Consensus Development Conference Panel for bariatric surgery, Bethesda, March 1991 NIH Consensus Development Conference Panel for bariatric surgery, Bethesda, March 1991
9.
go back to reference Fried I, Yumuk V, Oppert J, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Facts. 2013;6(5):449–68.CrossRefPubMed Fried I, Yumuk V, Oppert J, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Facts. 2013;6(5):449–68.CrossRefPubMed
10.
go back to reference Ramos A, Silva A, Ramos M, et al. Simplified gastric bypass: 13 years of experience and 12,000 patients operated. Arq Bras Cir Dig. 2014;27 Suppl 1:2–8.CrossRefPubMedPubMedCentral Ramos A, Silva A, Ramos M, et al. Simplified gastric bypass: 13 years of experience and 12,000 patients operated. Arq Bras Cir Dig. 2014;27 Suppl 1:2–8.CrossRefPubMedPubMedCentral
11.
go back to reference DeMaria E, Sugerman H, Kellum J, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235(5):640–5. discussion 645-7.CrossRefPubMedPubMedCentral DeMaria E, Sugerman H, Kellum J, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235(5):640–5. discussion 645-7.CrossRefPubMedPubMedCentral
12.
go back to reference Peterli R, Borbély Y, Kern B, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258(5):690–4. discussion 695.CrossRefPubMedPubMedCentral Peterli R, Borbély Y, Kern B, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258(5):690–4. discussion 695.CrossRefPubMedPubMedCentral
13.
go back to reference Dillemans B, Sakran N, Van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19(10):1355–64.CrossRefPubMedPubMedCentral Dillemans B, Sakran N, Van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19(10):1355–64.CrossRefPubMedPubMedCentral
14.
go back to reference Dogan K, Kraaij L, Aarts E, et al. Fast-track bariatric surgery improves perioperative care and logistics compared to conventional care. Obes Surg. 2015;25(1):28–35.CrossRefPubMed Dogan K, Kraaij L, Aarts E, et al. Fast-track bariatric surgery improves perioperative care and logistics compared to conventional care. Obes Surg. 2015;25(1):28–35.CrossRefPubMed
15.
go back to reference Myers SR, McGuirl J, Wang J. Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes. Obes Surg. 2013;23(4):467–73.CrossRefPubMed Myers SR, McGuirl J, Wang J. Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes. Obes Surg. 2013;23(4):467–73.CrossRefPubMed
16.
go back to reference Park C, Lam E, Walsh T, et al. Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: the future of bariatric surgery? Surg Endosc. 2011;25(10):3312–21.CrossRefPubMed Park C, Lam E, Walsh T, et al. Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: the future of bariatric surgery? Surg Endosc. 2011;25(10):3312–21.CrossRefPubMed
17.
go back to reference Hagen M, Inan I, Pugin F, et al. The da Vinci surgical system in digestive surgery. Rev Med Suisse. 2007;3(117):1622–6.PubMed Hagen M, Inan I, Pugin F, et al. The da Vinci surgical system in digestive surgery. Rev Med Suisse. 2007;3(117):1622–6.PubMed
18.
go back to reference Benizri E, Renaud M, Reibel N, et al. Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study. Am J Surg. 2013;206(2):145–51.CrossRefPubMed Benizri E, Renaud M, Reibel N, et al. Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study. Am J Surg. 2013;206(2):145–51.CrossRefPubMed
19.
go back to reference Buchs N, Morel P, Azagury D, et al. Laparoscopic versus robotic Roux-En-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014;24(12):2031–9.CrossRefPubMed Buchs N, Morel P, Azagury D, et al. Laparoscopic versus robotic Roux-En-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014;24(12):2031–9.CrossRefPubMed
20.
go back to reference Yu S, Clapp B, Lee M, et al. Robotic assistance provides excellent outcomes during the learning curve for laparoscopic Roux-en-Y gastric bypass: results from 100 robotic-assisted gastric bypasses. Am J Surg. 2006;192(6):746–9.CrossRefPubMed Yu S, Clapp B, Lee M, et al. Robotic assistance provides excellent outcomes during the learning curve for laparoscopic Roux-en-Y gastric bypass: results from 100 robotic-assisted gastric bypasses. Am J Surg. 2006;192(6):746–9.CrossRefPubMed
21.
go back to reference Ayloo S, Addeo P, Shah G, et al. Robot-assisted hybrid laparoscopic Roux-en-Y gastric bypass: surgical technique and early outcomes. J Laparoendosc Adv Surg Tech A. 2010;20(10):847–50.CrossRefPubMed Ayloo S, Addeo P, Shah G, et al. Robot-assisted hybrid laparoscopic Roux-en-Y gastric bypass: surgical technique and early outcomes. J Laparoendosc Adv Surg Tech A. 2010;20(10):847–50.CrossRefPubMed
22.
go back to reference Artuso D, Wayne M, Grossi R. Use of robotics during laparoscopic gastric bypass for morbid obesity. JSLS. 2005;9(3):266–8.PubMedPubMedCentral Artuso D, Wayne M, Grossi R. Use of robotics during laparoscopic gastric bypass for morbid obesity. JSLS. 2005;9(3):266–8.PubMedPubMedCentral
23.
go back to reference Mohr C, Nadzam G, Alami R, et al. Totally robotic laparoscopic Roux-en-Y Gastric bypass: results from 75 patients. Obes Surg. 2006;16(6):690–6.CrossRefPubMed Mohr C, Nadzam G, Alami R, et al. Totally robotic laparoscopic Roux-en-Y Gastric bypass: results from 75 patients. Obes Surg. 2006;16(6):690–6.CrossRefPubMed
24.
go back to reference Hagen M, Pugin F, Chassot G, et al. Reducing cost of surgery by avoiding complications: the model of robotic Roux-en-Y gastric bypass. Obes Surg. 2012;22(1):52–61.CrossRefPubMed Hagen M, Pugin F, Chassot G, et al. Reducing cost of surgery by avoiding complications: the model of robotic Roux-en-Y gastric bypass. Obes Surg. 2012;22(1):52–61.CrossRefPubMed
25.
go back to reference Hubens G, Balliu L, Ruppert M, et al. Roux-en-Y gastric bypass procedure performed with the da Vinci robot system: is it worth it? Surg Endosc. 2008;22(7):1690–6.CrossRefPubMed Hubens G, Balliu L, Ruppert M, et al. Roux-en-Y gastric bypass procedure performed with the da Vinci robot system: is it worth it? Surg Endosc. 2008;22(7):1690–6.CrossRefPubMed
26.
go back to reference Bailey J, Hayden J, Davis P, et al. Robotic versus laparoscopic Roux-en-Y gastric bypass (RYGB) in obese adults ages 18 to 65 years: a systematic review and economic analysis. Surg Endosc. 2014;28(2):414–26.CrossRefPubMed Bailey J, Hayden J, Davis P, et al. Robotic versus laparoscopic Roux-en-Y gastric bypass (RYGB) in obese adults ages 18 to 65 years: a systematic review and economic analysis. Surg Endosc. 2014;28(2):414–26.CrossRefPubMed
27.
go back to reference Sanchez B, Mohr C, Morton J, et al. Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(6):549–54.CrossRefPubMed Sanchez B, Mohr C, Morton J, et al. Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(6):549–54.CrossRefPubMed
28.
go back to reference Scozzari G, Rebecchi F, Millo P, et al. Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2011;25(2):597–603.CrossRefPubMed Scozzari G, Rebecchi F, Millo P, et al. Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2011;25(2):597–603.CrossRefPubMed
29.
go back to reference Snyder B, Wilson T, Leong B, et al. Robotic-assisted Roux-en-Y gastric bypass: minimizing morbidity and mortality. Obes Surg. 2010;20(3):265–70.CrossRefPubMed Snyder B, Wilson T, Leong B, et al. Robotic-assisted Roux-en-Y gastric bypass: minimizing morbidity and mortality. Obes Surg. 2010;20(3):265–70.CrossRefPubMed
30.
go back to reference Buchs NC, Morel P, Azagury DE, et al. Laparoscopic versus robotic Roux-en-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014;24(12):2031–9. doi:10.1007/s11695-014-1335-6.CrossRefPubMed Buchs NC, Morel P, Azagury DE, et al. Laparoscopic versus robotic Roux-en-Y gastric bypass: lessons and long-term follow-up learned from a large prospective monocentric study. Obes Surg. 2014;24(12):2031–9. doi:10.​1007/​s11695-014-1335-6.CrossRefPubMed
31.
go back to reference Tieu K, Allison N, Snyder B, et al. Robotic-assisted Roux-en-Y gastric bypass: update from 2 high-volume centers. Surg Obes Relat Dis. 2013;9(2):284–8.CrossRefPubMed Tieu K, Allison N, Snyder B, et al. Robotic-assisted Roux-en-Y gastric bypass: update from 2 high-volume centers. Surg Obes Relat Dis. 2013;9(2):284–8.CrossRefPubMed
32.
33.
go back to reference Deng J, Lourié D. 100 robotic-assisted laparoscopic gastric bypasses at a community hospital. Am Surg. 2008;74(10):1022–5.PubMed Deng J, Lourié D. 100 robotic-assisted laparoscopic gastric bypasses at a community hospital. Am Surg. 2008;74(10):1022–5.PubMed
34.
go back to reference Bindal V, Gonzalez-Heredia R, Masrur M, Elli EF. Technique evolution, learning curve, and outcomes of 200 robot-assisted gastric bypass procedures: a 5-year experience.Obes Surg. 2014;14. Bindal V, Gonzalez-Heredia R, Masrur M, Elli EF. Technique evolution, learning curve, and outcomes of 200 robot-assisted gastric bypass procedures: a 5-year experience.Obes Surg. 2014;14.
35.
go back to reference Bindal V, Bhatia P, Dudeja U, et al. Review of contemporary role of robotics in bariatric surgery. Surg Endosc. 2015;29(1):1–8.CrossRef Bindal V, Bhatia P, Dudeja U, et al. Review of contemporary role of robotics in bariatric surgery. Surg Endosc. 2015;29(1):1–8.CrossRef
36.
go back to reference Toro J, Lin E, Patel A. Review of robotics in foregut and bariatric surgery. J Minim Access Surg. 2015;11(1):16–21.CrossRef Toro J, Lin E, Patel A. Review of robotics in foregut and bariatric surgery. J Minim Access Surg. 2015;11(1):16–21.CrossRef
37.
go back to reference Buchs N, Pugin F, Bucher P, et al. Learning curve for robot-assisted Roux-en-Y gastric bypass. Surg Endosc. 2012;26(4):1116–21.CrossRefPubMed Buchs N, Pugin F, Bucher P, et al. Learning curve for robot-assisted Roux-en-Y gastric bypass. Surg Endosc. 2012;26(4):1116–21.CrossRefPubMed
38.
go back to reference Renaud M, Reibel N, Zarnegar R, et al. Multifactorial analysis of the learning curve for totally robotic Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2013;23(11):1753–60.CrossRefPubMed Renaud M, Reibel N, Zarnegar R, et al. Multifactorial analysis of the learning curve for totally robotic Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2013;23(11):1753–60.CrossRefPubMed
39.
go back to reference Lawson E, Curet M, Sanchez B, et al. Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. Robot Surg. 2007;1(1):61–7.CrossRef Lawson E, Curet M, Sanchez B, et al. Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. Robot Surg. 2007;1(1):61–7.CrossRef
Metadata
Title
The Results of 100 Robotic Versus 100 Laparoscopic Gastric Bypass Procedures: a Single High Volume Centre Experience
Authors
R. M. Smeenk
G. van ‘t Hof
E. Elsten
P. G. B. M. Feskens
Publication date
01-06-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1933-y

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