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Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass.
Surg Obes Relat Dis. 2005 Nov-Dec; 1(6):549-54.SO

Abstract

BACKGROUND

Laparoscopic gastric bypass is a technically demanding operation, especially when hand-sewing is required. Robotics may help facilitate the performance of this difficult operation. This study was undertaken to compare a single surgeon's results using the daVinci Surgical System with those using traditional laparoscopic Roux-en-Y gastric bypass (LRYGB) when the techniques were learned simultaneously.

METHODS

From July 2004 to April 2005, the new laparoscopic fellow's first 50 patients were randomized to undergo either LRYGB or totally robotic laparoscopic Roux-en-Y gastric bypass (TRRYGB). Data were collected on patient age, gender, body mass index (BMI), co-morbidities, operative time, complication rates, and length of stay. Student's t test with unequal variances was used for statistical analysis.

RESULTS

No significant differences in age, gender, co-morbidities, complication rates, or length of stay were found between the two groups. The mean operating time was significantly shorter for TRRYGB than for LRYGB (130.8 versus 149.4 minutes; P = 0.02), with a significant difference in minutes per BMI (2.94 versus 3.47 min/BMI; P = 0.02). The largest difference was in patients with a BMI >43 kg/m(2), for whom the difference in procedure time was 29.6 minutes (123.5 minutes for TRRYGB versus 153.2 minutes for LRYGB; P = 0.009) and a significant difference in minutes per BMI (2.49 versus 3.24 min/BMI; P = 0.009).

CONCLUSION

Our data indicate that the use of the daVinci Surgical System for TRRYGB is safe and feasible. The operating room time is shorter with the use of the robotic system during a surgeon's learning curve, and that decrease is maximized in patients with a larger BMI. TRRYGB may be a better approach to gastric bypass when hand-sewing is required, especially early in a surgeon's experience.

Authors+Show Affiliations

Department of Surgery, Stanford University Medical Center, Stanford, California 94305, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16925289

Citation

Sanchez, Barry R., et al. "Comparison of Totally Robotic Laparoscopic Roux-en-Y Gastric Bypass and Traditional Laparoscopic Roux-en-Y Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 1, no. 6, 2005, pp. 549-54.
Sanchez BR, Mohr CJ, Morton JM, et al. Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(6):549-54.
Sanchez, B. R., Mohr, C. J., Morton, J. M., Safadi, B. Y., Alami, R. S., & Curet, M. J. (2005). Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 1(6), 549-54.
Sanchez BR, et al. Comparison of Totally Robotic Laparoscopic Roux-en-Y Gastric Bypass and Traditional Laparoscopic Roux-en-Y Gastric Bypass. Surg Obes Relat Dis. 2005 Nov-Dec;1(6):549-54. PubMed PMID: 16925289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. AU - Sanchez,Barry R, AU - Mohr,Catherine J, AU - Morton,John M, AU - Safadi,Bassem Y, AU - Alami,Ramzi S, AU - Curet,Myriam J, PY - 2005/06/08/received PY - 2005/08/26/revised PY - 2005/08/26/accepted PY - 2006/8/24/pubmed PY - 2006/9/29/medline PY - 2006/8/24/entrez SP - 549 EP - 54 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 1 IS - 6 N2 - BACKGROUND: Laparoscopic gastric bypass is a technically demanding operation, especially when hand-sewing is required. Robotics may help facilitate the performance of this difficult operation. This study was undertaken to compare a single surgeon's results using the daVinci Surgical System with those using traditional laparoscopic Roux-en-Y gastric bypass (LRYGB) when the techniques were learned simultaneously. METHODS: From July 2004 to April 2005, the new laparoscopic fellow's first 50 patients were randomized to undergo either LRYGB or totally robotic laparoscopic Roux-en-Y gastric bypass (TRRYGB). Data were collected on patient age, gender, body mass index (BMI), co-morbidities, operative time, complication rates, and length of stay. Student's t test with unequal variances was used for statistical analysis. RESULTS: No significant differences in age, gender, co-morbidities, complication rates, or length of stay were found between the two groups. The mean operating time was significantly shorter for TRRYGB than for LRYGB (130.8 versus 149.4 minutes; P = 0.02), with a significant difference in minutes per BMI (2.94 versus 3.47 min/BMI; P = 0.02). The largest difference was in patients with a BMI >43 kg/m(2), for whom the difference in procedure time was 29.6 minutes (123.5 minutes for TRRYGB versus 153.2 minutes for LRYGB; P = 0.009) and a significant difference in minutes per BMI (2.49 versus 3.24 min/BMI; P = 0.009). CONCLUSION: Our data indicate that the use of the daVinci Surgical System for TRRYGB is safe and feasible. The operating room time is shorter with the use of the robotic system during a surgeon's learning curve, and that decrease is maximized in patients with a larger BMI. TRRYGB may be a better approach to gastric bypass when hand-sewing is required, especially early in a surgeon's experience. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/16925289/Comparison_of_totally_robotic_laparoscopic_Roux_en_Y_gastric_bypass_and_traditional_laparoscopic_Roux_en_Y_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(05)00739-2 DB - PRIME DP - Unbound Medicine ER -