Global benchmarks in primary robotic bariatric surgery redefine quality standards for Roux-en-Y gastric bypass and sleeve gastrectomy.

Autor:	Giudicelli G; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland., Gero D; Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Romulo L; Department of Surgery, Orlando Health, University of Central Florida, Orlando, Florida, USA., Chirumamilla V; Bariatric and Robotic Center of Excellence, Mather Northwell Hospital Health, Port Jefferson, New York, USA., Iranmanesh P; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.; Division of Minimally Invasive and Elective General Surgery, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA., Owen CK; Division of Minimally Invasive and Elective General Surgery, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA., Bauerle W; Department of Surgery, Division of Bariatric Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA., Garcia A; Endocrine-Metabolic and Bariatric Unit, Robotic Surgery, Vall Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain., Lucas L; Department of Endocrine and Digestive Surgery, University Hospital of Poitiers, Poitiers, France., Mehdorn AS; Department of General, Abdominal, Thoracic, Transplantation and Paediatric Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.; Kurt Semm Centre for Laparoscopic and Robot Assisted Surgery, University Hospital Schleswig-Holstein, Kiel, Germany., Pandey D; Institute of Minimal Access, Bariatric and Robotic Surgery, Max Super Speciality Hospital, Delhi NCR, India., Almuttawa A; Department of Endocrine and Digestive Surgery, Strasbourg University Hospital - IRCAD, Strasbourg, France.; Department of Surgery, University of Jeddah, Jeddah, Saudi Arabia., Cabral F; Robotic Surgery Unit, Cuf Tejo Hospital, Lisbon, Portugal., Tiwari A; Department of Surgery, Indraprastha Apollo Hospitals, New Delhi, India., Lambert V; Adelaide Bariatric Centre, Department of Surgery, Flinders University of South Australia, Adelaide, South Australia, Australia., Pascotto B; General and Minimally Invasive (Laparoscopic and Robotic) Surgery Department, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg., De Meyere C; Department of Surgery, AZ Groeninge Hospital, Kortrijk, Belgium., Yahyaoui M; Department of Digestive and Bariatric Surgery, Hôpital Edouard Herriot, Lyon, France., Haist T; Department of General and Visceral Surgery, Asklepios Paulinen Klinik, Wiesbaden, Germany., Scheffel O; Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach GmbH, Offenbach am Main, Germany., Robert M; Department of Digestive and Bariatric Surgery, Hôpital Edouard Herriot, Lyon, France., Nuytens F; Department of Surgery, AZ Groeninge Hospital, Kortrijk, Belgium., Azagra S; General and Minimally Invasive (Laparoscopic and Robotic) Surgery Department, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg., Kow L; Adelaide Bariatric Centre, Department of Surgery, Flinders University of South Australia, Adelaide, South Australia, Australia., Prasad A; Department of Surgery, Indraprastha Apollo Hospitals, New Delhi, India., Vaz C; Robotic Surgery Unit, Cuf Tejo Hospital, Lisbon, Portugal., Vix M; Department of Endocrine and Digestive Surgery, Strasbourg University Hospital - IRCAD, Strasbourg, France., Bindal V; Institute of Minimal Access, Bariatric and Robotic Surgery, Max Super Speciality Hospital, Delhi NCR, India., Beckmann JH; Department of General, Abdominal, Thoracic, Transplantation and Paediatric Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.; Kurt Semm Centre for Laparoscopic and Robot Assisted Surgery, University Hospital Schleswig-Holstein, Kiel, Germany., Soussi D; Department of Endocrine and Digestive Surgery, University Hospital of Poitiers, Poitiers, France., Vilallonga R; Endocrine-Metabolic and Bariatric Unit, Robotic Surgery, Vall Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain., El Chaar M; Department of Surgery, Division of Bariatric Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA., Wilson EB; Division of Minimally Invasive and Elective General Surgery, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA., Ahmad A; Bariatric and Robotic Center of Excellence, Mather Northwell Hospital Health, Port Jefferson, New York, USA., Teixeira A; Department of Surgery, Orlando Health, University of Central Florida, Orlando, Florida, USA., Hagen ME; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland., Toso C; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland., Clavien PA; Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Puhan M; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland., Bueter M; Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Jung MK; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2024 Jan 03; Vol. 111 (1).
DOI:	10.1093/bjs/znad374
Abstrakt:	Background: Whether the benefits of the robotic platform in bariatric surgery translate into superior surgical outcomes remains unclear. The aim of this retrospective study was to establish the 'best possible' outcomes for robotic bariatric surgery and compare them with the established laparoscopic benchmarks. Methods: Benchmark cut-offs were established for consecutive primary robotic bariatric surgery patients of 17 centres across four continents (13 expert centres and 4 learning phase centres) using the 75th percentile of the median outcome values until 90 days after surgery. The benchmark patients had no previous laparotomy, diabetes, sleep apnoea, cardiopathy, renal insufficiency, inflammatory bowel disease, immunosuppression, history of thromboembolic events, BMI greater than 50 kg/m2, or age greater than 65 years. Results: A total of 9097 patients were included, who were mainly female (75.5%) and who had a mean(s.d.) age of 44.7(11.5) years and a mean(s.d.) baseline BMI of 44.6(7.7) kg/m2. In expert centres, 13.74% of the 3020 patients who underwent primary robotic Roux-en-Y gastric bypass and 5.9% of the 4078 patients who underwent primary robotic sleeve gastrectomy presented with greater than or equal to one complication within 90 postoperative days. No patient died and 1.1% of patients had adverse events related to the robotic platform. When compared with laparoscopic benchmarks, robotic Roux-en-Y gastric bypass had lower benchmark cut-offs for hospital stay, postoperative bleeding, and marginal ulceration, but the duration of the operation was 42 min longer. For most surgical outcomes, robotic sleeve gastrectomy outperformed laparoscopic sleeve gastrectomy with a comparable duration of the operation. In robotic learning phase centres, outcomes were within the established benchmarks only for low-risk robotic Roux-en-Y gastric bypass. Conclusion: The newly established benchmarks suggest that robotic bariatric surgery may enhance surgical safety compared with laparoscopic bariatric surgery; however, the duration of the operation for robotic Roux-en-Y gastric bypass is longer. (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.)
Databáze:	MEDLINE
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