Assessment of predictors of early postoperative complications after primary robotically assisted Roux-en-Y gastric bypass: a multicenter, retrospective cohort study

Pouya Iranmanesh; Shinil K Shah; Mickael Chevallay; Christian Toso; Stefan P Mönig; Monika E Hagen; Erik B Wilson; Minoa K Jung

doi:10.1007/s00464-022-09766-x

Assessment of predictors of early postoperative complications after primary robotically assisted Roux-en-Y gastric bypass: a multicenter, retrospective cohort study

Surg Endosc. 2023 Apr;37(4):2851-2857. doi: 10.1007/s00464-022-09766-x. Epub 2022 Dec 9.

Authors

Pouya Iranmanesh^{1

2}, Shinil K Shah², Mickael Chevallay¹, Christian Toso¹, Stefan P Mönig¹, Monika E Hagen¹, Erik B Wilson², Minoa K Jung³

Affiliations

¹ Division of Digestive Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
² Division of Minimally Invasive and Elective General Surgery, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
³ Division of Digestive Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland. Minoa.Jung@hcuge.ch.

Abstract

Background: Robotic Roux-en-Y gastric bypass (RRYGB) is performed in an increasing number of bariatric centers worldwide. Previous studies have identified a number of demographic and clinical variables as predictors of postoperative complications after laparoscopic Roux-en-Y gastric bypass (LRYGB). Some authors have suggested better early postoperative outcomes after RRYGB compared to LRYGB. The objective of the present study was to assess potential predictors of early postoperative complications after RRYGB.

Methods: A retrospective analysis of two prospective databases containing patients who underwent RRYGB between 2006 and 2019 at two high volumes, accredited bariatric centers was performed. Primary outcome was rate of 30 day postoperative complications. Relevant demographic, clinical and biological variables were entered in a multivariate, logistic regression analysis to identify potential predictors.

Results: Data of 1276 patients were analyzed, including 958 female and 318 male patients. Rates of overall and severe 30 day complications were 12.5% (160/1276) and 3.9% (50/1276), respectively. Rate of 30 day reoperations was 1.6% (21/1276). The overall gastrointestinal leak rate was 0.2% (3/1276). Among various demographic, clinical and biological variables, male sex and ASA score >2 were significantly correlated with an increased risk of 30 day complication rates on multivariate analysis (OR 1.68 and 1.67, p=0.005 and 0.005, respectively).

Conclusion: This study identified male sex and ASA score >2 as independent predictors of early postoperative complications after RRYGB. These data suggest a potentially different risk profile in terms of early postoperative complications after RRYGB compared to LYRGB. The robotic approach might have a benefit for patients traditionally considered to be at higher risk of complications after LRYGB, such as those with BMI >50. The present study was however not designed to assess this hypothesis and larger, prospective studies are necessary to confirm these results.

Keywords: Bariatric surgery; Robotic surgery; Roux-en-Y gastric bypass.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Female
Gastric Bypass* / adverse effects
Humans
Laparoscopy* / adverse effects
Male
Obesity, Morbid* / surgery
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Prospective Studies
Retrospective Studies
Robotic Surgical Procedures* / adverse effects
Treatment Outcome