Robot-assisted versus Laparoscopic Roux-en-Y Gastric Bypass: Is There a Difference in Outcomes?

Autor: Nicolas C. Buchs, Pier Cristoforo Giulianotti, Subhashini Ayloo, Galaxy Shah, Pietro Addeo
Rok vydání: 2010
Předmět:
Adult
Male
medicine.medical_specialty
Surgical Procedures
Minimally Invasive/adverse effects/methods
Gastric bypass
Gastric Bypass
Body Mass Index
Cohort Studies
Postoperative Complications
Weight loss
Weight Loss
medicine
Humans
Minimally Invasive Surgical Procedures
Robotic surgery
Robotics/methods
Retrospective Studies
Laparoscopy/adverse effects/methods
Postoperative Complications/epidemiology/physiopathology
Pain
Postoperative
ddc:617
business.industry
Gastric Bypass/adverse effects/methods
technology
industry
and agriculture
Pain
Postoperative/physiopathology
Robotics
Length of Stay
Middle Aged
Vascular surgery
Roux-en-Y anastomosis
United States
Obesity
Morbid
Surgery
Cardiac surgery
body regions
Treatment Outcome
surgical procedures
operative
Obesity
Morbid/diagnosis/surgery
Cardiothoracic surgery
Female
Laparoscopy
medicine.symptom
business
human activities
Follow-Up Studies
Abdominal surgery
Zdroj: World Journal of Surgery, Vol. 35, No 3 (2011) pp. 637-42
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-010-0938-x
Popis: Application of the robot for Roux-en-Y gastric bypass has been slow to evolve, despite its rapid acceptance in other fields. This is largely due to associated costs of technology, reports of increased operative time, and inadequate data available to correlate the benefits of robotics to a clinical outcome. The authors present a comparative study between laparoscopic and robot-assisted Roux-en-Y gastric bypass performed at a specialized institution for robotic surgery. A total of 135 consecutive Roux-en-Y gastric bypass procedures were performed from January 2006 to December 2009 by a single surgeon. The first 45 were performed laparoscopically and the remaining 90 were robot-assisted. Patient demographics, operative time, complication rate, length of stay, long-term weight loss, and follow-up for the two groups were gathered from a prospectively maintained database and statistically analyzed. The overall operative time was significantly shorter for the robot-assisted procedures than for the laparoscopic procedures (207 ± 31 vs. 227 ± 31 min) (P = 0.0006). The robotic set-up time remained constant at 13 ± 4 min. 30 robotic cases were necessary in order to perform the procedure in less time than with the laparoscopic approach (P = 0.047). Mortality was 0% in both groups, with no conversions to open surgery and no transfusions. Early morbidities and percentage of excess weight loss at 1 year were comparable for the two groups. The use of the robot for performing the gastrojejunostomy during laparoscopic Roux-en-Y gastric bypass does not increase the operative time or the rate of specific complications. The short-term outcomes of the robot-assisted procedure are comparable to those found with the conventional laparoscopic method.
Databáze: OpenAIRE
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