Technical aspects and standardization of the totally robotic Roux-en-Y gastric bypass. Results of a single surgeon experience with a 5-year follow-up

Acta Chir Belg. 2022 Jun;122(3):169-177. doi: 10.1080/00015458.2021.1889134. Epub 2021 Feb 18.

Abstract

Introduction: The use of robotics in bariatric surgery is increasing worldwide, with as main objective reducing complications and optimising surgical outcome. This study presents the results of a single surgeon 8-year experience with a totally robotic Roux-en-Y gastric bypass (RYGB).

Methods: A total of 183 consecutive patients underwent a robotic bariatric procedure. A retrospective analysis was performed of all patient files to obtain patient characteristics, weight loss results and per- and postoperative morbidity. For long-term follow-up all patients were contacted one by one.

Results: In 155/183 patients, a primary RYGB was performed, 23 procedures were revisional cases and in 5 other procedures were performed. Mean initial weight was 112.07 (±20.5) kg, mean start BMI was 40.8 (±5.36) kg/m2. There were no conversions and no major intraoperative complications. In the early postoperative period we note two revisions; one postoperative bleeding and one missed iatrogenic enterotomy. Mean length of stay in the hospital was 3.50 (±1.20) days. After a mean follow-up of 62.06 (±32.76) months, mean BMI was 28.07 (±4.88) kg/m2 with an % excess body mass index loss of 84.02 (±31.64) %. Patient satisfaction was high, with 95.1% of the patients being happy. The main complaint in the remaining patients was weight regain.

Conclusion: The robotic RYGB is a safe and reproducible approach to treat morbid obesity. A secure hand-sewn gastrojejunal anastomosis, quick recovery and better ergonomics are the main advantages of this technique.

Keywords: RYGB standardization; Robotic surgery; bariatric surgery; weight loss surgery.

MeSH terms

  • Follow-Up Studies
  • Gastric Bypass* / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / surgery
  • Reference Standards
  • Reoperation / methods
  • Retrospective Studies
  • Surgeons*
  • Treatment Outcome