Robot-Assisted Roux-en-Y Gastric Bypass for Super Obese Patients: A Comparative Study
Open Access
- 27 November 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Obesity Surgery
- Vol. 23 (3), 353-357
- https://doi.org/10.1007/s11695-012-0824-8
Abstract
Superobese patients (SO) (body mass index (BMI) ≥ 50 kg/m2) represent a real surgical challenge and the best management remains debatable. While the safety of a laparoscopic approach has been questioned for this population, robotics has been introduced in the armamentarium of the bariatric surgeon, yet its role remains poorly assessed, especially for a very high BMI. The study aim is thus to report our experience with robot-assisted Roux-en-Y gastric bypass (RYGB) for SO. From July 2006 to May 2012, 288 consecutive robot-assisted RYGB procedures have been performed at a single institution. All data were collected prospectively in a dedicated database. Among those patients, 41 were SO (14.2 %). All the peri- and postoperative parameters were compared to the morbidly obese (MO) group (BMI < 50). Data have been reviewed retrospectively. The SO group presented a higher ASA score and more male patients. The operative time was similar between both groups, yet there were more conversions in the SO group (two versus one for MO; p = 0.05). The morbidity and mortality rates were similar between both groups. The length of stay was longer for the SO population (7 vs. 6 days; p = 0.03). The percent BMI loss was similar at 1 year (34 vs. 34 %; p = 1), but the percent excess BMI loss was higher for the MO group (83 vs. 65 % for the SO group; p = 0.0007). Robot-assisted RYGB can be performed safely for SO, with complication rates and functional results at 1 year comparable to MO, yet this approach for SO has been associated with a slightly increased conversion rate and length of stay.Keywords
This publication has 38 references indexed in Scilit:
- Laparoscopic Sleeve Gastrectomy as a Primary Operation for Morbid Obesity: Experience with 200 PatientsGastroenterology Research and Practice, 2012
- Multifactorial Analysis of the Learning Curve for Robot-Assisted Laparoscopic Biliopancreatic Diversion With Duodenal SwitchAnnals of Surgery, 2012
- Learning curve for robot-assisted Roux-en-Y gastric bypassSurgical Endoscopy, 2011
- Robotic vs. laparoscopic Roux‐en‐Y gastric bypass in morbidly obese patients: systematic review and pooled analysisInternational Journal of Medical Robotics and Computer Assisted Surgery, 2011
- Are laparoscopic bariatric procedures safe in superobese (BMI ≥50 kg/m2) patients? An NSQIP data analysisSurgery for Obesity and Related Diseases, 2011
- Reducing Cost of Surgery by Avoiding Complications: the Model of Robotic Roux-en-Y Gastric BypassObesity Surgery, 2011
- Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypassSurgical Endoscopy, 2010
- Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 YearsAnnals of Surgery, 2006
- Duodenal Switch Provides Superior Weight Loss in the Super-Obese (BMI ???50kg/m2) Compared With Gastric BypassTransactions of the ... Meeting of the American Surgical Association, 2006
- The Optimal Surgical Management of the Super Obese Patient: The DebateSurgical Innovation, 2005