DaVinci® Robotic-Assisted Laparoscopic Bariatric Surgery: Is it Justified in a Routine Setting?
| Autor: | Franz Aigner, Helmut Weiss, Elisabeth Höller, Gilbert Mühlmann, Werner Kirchmayr, Hermann Nehoda, Alexander Klaus, Andreas Unger, Heinz Wykypiel |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Adolescent Gastroplasty Robotic assisted Endocrinology Diabetes and Metabolism Conventional laparoscopy Hospitals University Morbid obesity Pneumoperitoneum Humans Medicine Surgical treatment Laparoscopy Nutrition and Dietetics medicine.diagnostic_test business.industry Robotics Middle Aged medicine.disease Surgery Treatment Outcome Surgery Computer-Assisted Costs and Cost Analysis Cost analysis Feasibility Studies Operative time Female business |
| Zdroj: | Obesity Surgery. 13:848-854 |
| ISSN: | 1708-0428 0960-8923 |
| Popis: | Laparoscopic silicone adjustable gastric banding (SAGB) has gained popularity for the surgical treatment of morbid obesity. The implantable gastric stimulator (IGS) system represents a novel surgical alternative. We aimed to assess the feasibility of robotic-assisted laparoscopic bariatric operations and to critically elucidate the technical and financial advantages and patient outcome.Robotic-assisted laparoscopic bariatric procedures were performed on 10 consecutive patients using the daVinci robot system (4 SAGB, 4 IGS, 2 SAGB revisions). 10 conventional laparoscopic-operated patients (4 SAGB, 4 IGS, 2 SAGB revisions) during the learning curve served as controls. Equipment, operative technique and procedural time were evaluated. A cost analysis was calculated.The personnel equipment, numbers of trocars and operation technique were comparable in both groups. The mean operative time was 137 min (range 110-175) and 97 min (60-140) in robotic-assisted and conventional laparoscopy, respectively (P =0.04). Establishment of the pneumoperitoneum and placement of trocars and robotic arms took a mean of 30 min (15-45) in the robotic-assisted group, compared with 5 min in the control group (P0.001). In 1 patient, intraoperative gastric injury was suspected and led to band removal in the robotic-assisted group. There was no postoperative complication. Average procedural costs were significantly higher in the robotic-assisted group.Primary and revisional robotic-assisted bariatric surgery is technically simple, with the benefit of precise instrument handling. However, it is still expensive, the set-up of the system is time-consuming, and a limited variety of instruments are available presently. |
| Databáze: | OpenAIRE |
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