Skip to main content
Top
Published in: Obesity Surgery 9/2014

01-09-2014 | Original Contributions

Comparison of the Morbidity, Weight Loss, and Relative Costs between Robotic and Laparoscopic Sleeve Gastrectomy for the Treatment of Obesity in Brazil

Authors: Vladimir Schraibman, Antonio L. V. Macedo, Marina G Epstein, Mayte Y. Soares, Gabriel Maccapani, Delcio Matos, Luiz Vicente Rizzo, Suzan M. Goldman

Published in: Obesity Surgery | Issue 9/2014

Login to get access

Abstract

Background

In recent years, there has been renewed interest in using robotics in bariatric surgery for the treatment of morbid obesity. However, the high cost of a robotic surgical system has hindered its widespread use in developing countries. This study aims to compare the rate of morbidity, weight loss, and relative costs between laparoscopic (LSG) and robotic-assisted sleeve gastrectomy (RSG) performed for the treatment of obesity in a single center in Brazil.

Methods

From January 2011 to March 2013, 48 severely obese patients underwent either LSG or RSG at our institution and were prospectively followed up for 12 months. Patients were free to choose either approach and were informed of any extra costs that may be incurred

Results

Thirty-two patients underwent LSG and 16 patients, RSG. No significant differences were observed between LSG and RSG groups regarding age, sex, BMI, incidence of comorbidities, duration of surgery, and length of hospital stay. Also, there were no significant between-group differences in BMI values evaluated at 6 and 12 months after surgery. Surgical costs were almost twice as high and total hospital costs were approximately 50 % higher in the robotic approach compared to the laparoscopic approach

Conclusion

Both RSG and LSG had excellent and similar post-operative clinical outcomes. However, the much higher costs of purchasing and maintaining the robotic system are still precluding the use of RSG as a routine approach in the treatment of morbid obesity in Brazil.
Literature
1.
go back to reference Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.PubMedCrossRef Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.PubMedCrossRef
2.
3.
4.
go back to reference Aggarwal S, Kini SU, Herron DM. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3(2):189–94.PubMedCrossRef Aggarwal S, Kini SU, Herron DM. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3(2):189–94.PubMedCrossRef
5.
go back to reference Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg. 2004;188(4A Suppl):38S–44S.PubMedCrossRef Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg. 2004;188(4A Suppl):38S–44S.PubMedCrossRef
6.
go back to reference Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11(6):415–9.PubMedCrossRef Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11(6):415–9.PubMedCrossRef
7.
go back to reference Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech A. 2003;13(4):279–83.PubMedCrossRef Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech A. 2003;13(4):279–83.PubMedCrossRef
8.
go back to reference Schauer P, Ikramuddin S, Hamad G, et al. The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc. 2003;17(2):212–5. Epub 2002 Dec 4.PubMedCrossRef Schauer P, Ikramuddin S, Hamad G, et al. The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc. 2003;17(2):212–5. Epub 2002 Dec 4.PubMedCrossRef
9.
go back to reference Cadiere GB, Himpens J, Vertruyen M, et al. The world’s first obesity surgery performed by a surgeon at a distance. Obes Surg. 1999;9(2):206–9.PubMedCrossRef Cadiere GB, Himpens J, Vertruyen M, et al. The world’s first obesity surgery performed by a surgeon at a distance. Obes Surg. 1999;9(2):206–9.PubMedCrossRef
10.
go back to reference Diamantis T, Alexandrou A, Pikoulis E, et al. Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopic guidance. Immediate peri-operative and 1-year results after 25 patients. Obes Surg. 2010;20(8):1164–70.PubMedCrossRef Diamantis T, Alexandrou A, Pikoulis E, et al. Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopic guidance. Immediate peri-operative and 1-year results after 25 patients. Obes Surg. 2010;20(8):1164–70.PubMedCrossRef
11.
go back to reference Hubens G, Balliu L, Ruppert M, et al. Gastric bypass procedure performed with the da Vinci robot system: is it worth it? Surg Endosc. 2008;22(7):1690–6. Epub 2007 Dec 11.PubMedCrossRef Hubens G, Balliu L, Ruppert M, et al. Gastric bypass procedure performed with the da Vinci robot system: is it worth it? Surg Endosc. 2008;22(7):1690–6. Epub 2007 Dec 11.PubMedCrossRef
12.
go back to reference Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779–86.PubMedCrossRef Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779–86.PubMedCrossRef
13.
go back to reference Yu SC, Clapp BL, Lee MJ, 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.PubMedCrossRef Yu SC, Clapp BL, Lee MJ, 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.PubMedCrossRef
14.
go back to reference Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18(10):1251–6. Epub 2008 Jul 29.PubMedCrossRef Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18(10):1251–6. Epub 2008 Jul 29.PubMedCrossRef
15.
go back to reference Schraibman V, Macedo ALV, Okazaki S, et al. Surgical treatment of hiatus hernia and gastroesophageal reflux disease in complex cases using robotic-assisted laparoscopic surgery: a prospective study/consistent experience in a single institution. J Robotic Surg. 2011;5(1):29–33.CrossRef Schraibman V, Macedo ALV, Okazaki S, et al. Surgical treatment of hiatus hernia and gastroesophageal reflux disease in complex cases using robotic-assisted laparoscopic surgery: a prospective study/consistent experience in a single institution. J Robotic Surg. 2011;5(1):29–33.CrossRef
16.
go back to reference Macedo ALV, Schraibman V, Okazaki S, et al. Treatment of intraductal papillary mucinous neoplasms, neuroendocrine and periampullary pancreatic tumors using robotic surgery: a safe and feasible technique. J Robotic Surg. 2011;5(1):35–41.CrossRef Macedo ALV, Schraibman V, Okazaki S, et al. Treatment of intraductal papillary mucinous neoplasms, neuroendocrine and periampullary pancreatic tumors using robotic surgery: a safe and feasible technique. J Robotic Surg. 2011;5(1):35–41.CrossRef
Metadata
Title
Comparison of the Morbidity, Weight Loss, and Relative Costs between Robotic and Laparoscopic Sleeve Gastrectomy for the Treatment of Obesity in Brazil
Authors
Vladimir Schraibman
Antonio L. V. Macedo
Marina G Epstein
Mayte Y. Soares
Gabriel Maccapani
Delcio Matos
Luiz Vicente Rizzo
Suzan M. Goldman
Publication date
01-09-2014
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1239-5

Other articles of this Issue 9/2014

Obesity Surgery 9/2014 Go to the issue