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

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:

• Robotic surgery
• bariatric surgery
• weight loss surgery
• RYGB standardization

Disclosure statement

ER declares no conflicts of interest.

VV declares no conflicts of interest.

KH declares no conflicts of interest.

DV declares no conflicts of interest.

CV Consultant for Intuitive Surgical Inc.

Consultant for Medtronic.

Conflicts of Interest Carlos Vaz.

Consultant for Intuitive Surgical Inc.

Consultant for Medtronic.

Other authors no conflict of interest.