Comparison of robotic revisional weight loss surgery and laparoscopic revisional weight loss surgery using the MBSAQIP database

Benjamin Clapp; Evan Liggett; Robert Jones; Carlos Lodeiro; Christopher Dodoo; Alan Tyroch

doi:10.1016/j.soard.2019.03.022

Comparison of robotic revisional weight loss surgery and laparoscopic revisional weight loss surgery using the MBSAQIP database

Surg Obes Relat Dis. 2019 Jun;15(6):909-919. doi: 10.1016/j.soard.2019.03.022. Epub 2019 Mar 22.

Authors

Benjamin Clapp¹, Evan Liggett², Robert Jones², Carlos Lodeiro², Christopher Dodoo², Alan Tyroch²

Affiliations

¹ Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, Texas. Electronic address: B_clapp@hotmail.com.
² Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, Texas.

PMID: 31101566
DOI: 10.1016/j.soard.2019.03.022

Abstract

Background: The most common bariatric operation in the United States is sleeve gastrectomy. The second and third most common bariatric operations are gastric bypass and revisional bariatric surgery, respectively.

Objective: The objective of the study was to assess the differences between laparoscopic revisional weight loss surgery (LRWLS) and robotic revisional weight loss surgery (RRWLS).

Setting: University hospital, United States.

Methods: Data were extracted from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database spanning 2015 to 2016 to look at demographic characteristics, operative time, co-morbidities, and length of stay. Using the specified Current Procedural Terminology codes, patients who underwent bariatric procedures and required a revisional procedure were identified.

Results: A total of 354,865 patients were included in this study; 37,917 (11.9%) patients required revision after undergoing a bariatric procedure. Of these revisions, 94.9% (n = 35,988) were LRWLS, and 5.1% (n = 1929) were RRWLS. There were no differences in patient characteristics between the LRWLS and RRWLS groups. There was a significant difference between the RRWLS and the LRWLS groups in operative time, with the RRWLS group taking 167 minutes and the LRWLS group taking 103 minutes (P < .001). There was a statistically significant increase in length of stay for RRWLS, 2.3 days versus 1.7 for LRWLS (P < .005). In terms of postoperative complications, there were no significant differences between the 2 groups.

Conclusions: RRWLS is as safe as LRWLS in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. There is an increase in operative times and length of stay for robotic cases.

Keywords: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP); Revisional bariatric surgery; Revisional gastric bypass; Revisional sleeve gastrectomy.

Publication types

Comparative Study

MeSH terms

Adult
Bariatric Surgery* / adverse effects
Bariatric Surgery* / methods
Bariatric Surgery* / statistics & numerical data
Female
Humans
Laparoscopy* / adverse effects
Laparoscopy* / methods
Laparoscopy* / statistics & numerical data
Male
Middle Aged
Obesity, Morbid / surgery
Operative Time
Postoperative Complications
Reoperation* / adverse effects
Reoperation* / methods
Reoperation* / statistics & numerical data
Retrospective Studies
Robotic Surgical Procedures* / adverse effects
Robotic Surgical Procedures* / methods
Robotic Surgical Procedures* / statistics & numerical data
Treatment Outcome
Weight Loss