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Obesity Surgery
Published in: Obesity Surgery 4/2021

01-04-2021 | Sleeve Gastrectomy | Original Contributions

Robotic Revisional Bariatric Surgery: a High-Volume Center Experience

Authors: Nicolas H. Dreifuss, Alberto Mangano, Chandra Hassan, Mario A. Masrur

Published in: Obesity Surgery | Issue 4/2021

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Abstract

Purpose

The number of bariatric revisional procedures is growing. Scarce evidence is available regarding the role and postoperative outcomes of robotic-assisted revisional bariatric surgery (RRBS). The aim of this study is to evaluate the safety and postoperative outcomes of RRBS.

Materials and Methods

A retrospective analysis of a prospectively collected database of patients who underwent RRBS between 2012 and 2019 was performed. Primary outcomes of interest were 30-day major morbidity, mortality, length of hospital stay (LOS), urgent reoperation rates, and percentage of total weight loss (%TWL).

Results

RRBS was performed in 76 patients; among these 60 (78.9%) underwent conversion to Roux-en-Y gastric bypass (C-RYGB). Failed weight loss (76%) and gastroesophageal reflux (9.2%) were the main indications for revision. Primary bariatric procedures included gastric band (LAGB) (50%), sleeve gastrectomy (SG) (40.8%), and RYGB (6.6%). Major morbidity and mortality rates were 3.9% and 1.3%, respectively. Mean LOS was 2.1 days, and 3 patients (3.9%) required urgent reoperation. The %TWL at 3, 6, 12, and 24 months was 10.2%, 16.6%, 18.3%, and 22.4% respectively. Comparative analysis of C-RYGB after failed LAGB and SG showed similar morbidity. Higher readmission rates (SG: 22.2% vs. LAGB: 0%, p = 0.007) and lower %EWL at 3, 6, 12, and 24 months were found in C-RYGB after SG.

Conclusion

This is one of the largest single-center series of RRBS published in the literature; the data indicate that robotic approach for revisional bariatric surgery is safe and helps achieving further weight loss. RRBS outcomes might be influenced by the primary procedure.
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Metadata
Title
Robotic Revisional Bariatric Surgery: a High-Volume Center Experience
Authors
Nicolas H. Dreifuss
Alberto Mangano
Chandra Hassan
Mario A. Masrur
Publication date
01-04-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05174-z

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