Revisional Robotic Bariatric Surgery. Largest Single Centre Prospective Cohort Study and Review of the Literature

Chirurgia (Bucur). 2023 Oct;118(5):455-463. doi: 10.21614/chirurgia.2023.v.118.i.5.p.455.

Abstract

Introduction: Robotic bariatric surgery (RBS) has seen a surge in popularity in recent years, yet questions persist about its utility concerning postoperative complications, costs, and technical aspects. RBS, while increasing in number, presents a greater technical challenge associated with more post-operative complications compared to primary bariatric surgery. In this study, we present our single institution experience and review the literature to assess the value of robotic revisional surgery. Material and Method: The retrospective review involved 42 patients (31 females, 11 males) who underwent various procedures, with the most frequent being the conversion of sleeve gastrectomy to gastric bypass (n=30). Encouragingly, no leaks or severe complications were identified. Furthermore, a systematic review indicated comparable outcomes, with decreased complication rates favoring robotic revisional surgery. Results: In direct comparison to standard laparoscopic revisional bariatric surgery, revisional robotic surgery demonstrated superior results in terms of efficacy, safety, and reduced hospital stay. However, rates of mortality, morbidity, and reintervention did not significantly differ between the two approaches. Conclusions: Considering these findings, we advocate for surgeons to acquire proficiency in the robotic technique, as part of the broader process of democratization and standardization of bariatric surgery. Embracing revisional robotic bariatric surgery can lead to improved patient outcomes, and its wider implementation may lead to enhanced surgical care and patient satisfaction in the field of bariatric procedures.

Keywords: DaVinci; RevisionalSurgery; baroatricsurgery; complications; roboticsurgery.

Publication types

  • Systematic Review

MeSH terms

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