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01-12-2018

Perioperative outcomes and anesthetic considerations of robotic bariatric surgery in a propensity-matched cohort of super obese and super-super obese patients

Authors: Katherine D. Gray, Alfons Pomp, Gregory Dakin, Sonia Amanat, Zachary A. Turnbull, Jon Samuels, Cheguevara Afaneh

Published in: Surgical Endoscopy | Issue 12/2018

Abstract

Background

The use of the robotic platform has not been well established in patients with super obesity (SO; body mass index, BMI ≥ 50) and super-super obesity (SSO, BMI ≥ 60). We aimed to determine safety and feasibility of robotic bariatric surgery in this cohort.

Methods

Review of a prospectively maintained database was performed of consecutive patients undergoing robotic bariatric surgery between 2015 and 2017. Propensity score analysis with 1:2 nearest neighbor matching was performed to control for baseline characteristics and procedure type.

Results

A propensity-matched cohort of 47 SO patients (median BMI 55.3, range 50.1–92.5) and 94 morbidly obese (MO; median BMI 41.8, range 35.1–48.8) patients were analyzed. After matching, there were no difference in baseline characteristics including age, American Society of Anesthesiologists (ASA) score, or preoperative comorbidities. Most patients in each group underwent sleeve gastrectomy (81% of SO patients versus 76% of MO patients) or Roux-en-Y gastric bypass (13% vs. 18%, respectively), p = 0.66. There were no differences in operative time, intraoperative complications, postoperative complications, or re-admissions between groups. Length of stay was slightly longer in the MO group (2.2 days, IQR 1.8–3.2 vs. 1.8 days, IQR 1.2–2.7; p = 0.01). A subset of SSO patients (n = 11, median BMI 67, range 60–92) was analyzed; there was no increase in operation time, and zero intraoperative complications, conversions to open, or postoperative complications in this subset.

Conclusions

Robotic bariatric surgery can safely be performed on patients with SO or SSO with low perioperative morbidity and no increase in operating time.

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Title: Perioperative outcomes and anesthetic considerations of robotic bariatric surgery in a propensity-matched cohort of super obese and super-super obese patients
Authors: Katherine D. Gray
Alfons Pomp
Gregory Dakin
Sonia Amanat
Zachary A. Turnbull
Jon Samuels
Cheguevara Afaneh
Publication date: 01-12-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6241-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Perioperative outcomes and anesthetic considerations of robotic bariatric surgery in a propensity-matched cohort of super obese and super-super obese patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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