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Totally robotic Roux-en-Y gastric bypass.
Arch Surg 2005; 140(8):779-86AS

Abstract

HYPOTHESIS

We hypothesized that we could develop a safe and effective technique for performing a totally robotic laparoscopic Roux-en-Y gastric bypass procedure using the da Vinci surgical system. We anticipated that the learning curve for this totally robotic procedure could be shorter than the learning curve for standard laparoscopic bariatric surgery.

DESIGN

Retrospective case comparison study.

SETTING

Academic tertiary care center.

PATIENTS

Consecutive samples of patients who met National Institutes of Health (NIH) criteria for morbid obesity and who completed the Stanford Bariatric Surgery Program evaluation process.

INTERVENTION

A port placement and robot positioning scheme was developed so that the entire case could be performed robotically. The first 10 patients who underwent a totally robotic laparoscopic Roux-en-Y gastric bypass were compared with a retrospective sample of 10 patients who had undergone laparoscopic Roux-en-Y gastric bypass surgery.

MAIN OUTCOME MEASURES

Patient age, gender, body mass index (BMI), numbers of NIH-defined comorbidities, operative time, length of stay, and complications.

RESULTS

No significant differences existed between the 2 patient series with regard to age, gender, or BMI. The median surgical times were significantly lower for the robotic procedures (169 vs 208 minutes; P = .03), as was the ratio of procedure time to BMI (3.8 vs 5.0 minutes per BMI for the laparoscopic cases; P = .04).

CONCLUSIONS

This study details the first report, to our knowledge, of a totally robotic laparoscopic Roux-en-Y gastric bypass and demonstrates the feasibility, safety, and potential superiority of such a procedure. In addition, the learning curve may be significantly shorter with the robotic procedure. Further experience is needed to understand the long-term advantages and disadvantages of the totally robotic approach.

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    Authors+Show Affiliations

    Mohr CJ
    Department of Surgery, Stanford School of Medicine, Stanford Hospital, 300 Pasteur Drive, Stanford, CA 94305, USA.
    Nadzam GS
    No affiliation info available
    Curet MJ
    No affiliation info available

    MeSH

    AdultAnastomosis, Roux-en-YBody Mass IndexCohort StudiesFemaleFollow-Up StudiesGastric BypassHumansLaparoscopyLength of StayMaleMiddle AgedObesity, MorbidPain, PostoperativeRetrospective StudiesRisk AssessmentRoboticsSensitivity and SpecificitySeverity of Illness IndexTreatment OutcomeWeight Loss

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    16103289

    Citation

    Mohr, Catherine J., et al. "Totally Robotic Roux-en-Y Gastric Bypass." Archives of Surgery (Chicago, Ill. : 1960), vol. 140, no. 8, 2005, pp. 779-86.
    Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779-86.
    Mohr, C. J., Nadzam, G. S., & Curet, M. J. (2005). Totally robotic Roux-en-Y gastric bypass. Archives of Surgery (Chicago, Ill. : 1960), 140(8), pp. 779-86.
    Mohr CJ, Nadzam GS, Curet MJ. Totally Robotic Roux-en-Y Gastric Bypass. Arch Surg. 2005;140(8):779-86. PubMed PMID: 16103289.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Totally robotic Roux-en-Y gastric bypass. AU - Mohr,Catherine J, AU - Nadzam,Geoffrey S, AU - Curet,Myriam J, PY - 2005/8/17/pubmed PY - 2005/9/2/medline PY - 2005/8/17/entrez SP - 779 EP - 86 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 140 IS - 8 N2 - HYPOTHESIS: We hypothesized that we could develop a safe and effective technique for performing a totally robotic laparoscopic Roux-en-Y gastric bypass procedure using the da Vinci surgical system. We anticipated that the learning curve for this totally robotic procedure could be shorter than the learning curve for standard laparoscopic bariatric surgery. DESIGN: Retrospective case comparison study. SETTING: Academic tertiary care center. PATIENTS: Consecutive samples of patients who met National Institutes of Health (NIH) criteria for morbid obesity and who completed the Stanford Bariatric Surgery Program evaluation process. INTERVENTION: A port placement and robot positioning scheme was developed so that the entire case could be performed robotically. The first 10 patients who underwent a totally robotic laparoscopic Roux-en-Y gastric bypass were compared with a retrospective sample of 10 patients who had undergone laparoscopic Roux-en-Y gastric bypass surgery. MAIN OUTCOME MEASURES: Patient age, gender, body mass index (BMI), numbers of NIH-defined comorbidities, operative time, length of stay, and complications. RESULTS: No significant differences existed between the 2 patient series with regard to age, gender, or BMI. The median surgical times were significantly lower for the robotic procedures (169 vs 208 minutes; P = .03), as was the ratio of procedure time to BMI (3.8 vs 5.0 minutes per BMI for the laparoscopic cases; P = .04). CONCLUSIONS: This study details the first report, to our knowledge, of a totally robotic laparoscopic Roux-en-Y gastric bypass and demonstrates the feasibility, safety, and potential superiority of such a procedure. In addition, the learning curve may be significantly shorter with the robotic procedure. Further experience is needed to understand the long-term advantages and disadvantages of the totally robotic approach. SN - 0004-0010 UR - https://www.unboundmedicine.com/medline/citation/16103289/Totally_robotic_Roux_en_Y_gastric_bypass_ L2 - https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.140.8.779 DB - PRIME DP - Unbound Medicine ER -