Gastric pouch formation using EWSS during robotic gastric bypass surgery is feasible. Due to the shorter length of EWSS compared to EFES, more stapling recharges are required to complete gastric pouch formation and the stapling costs for gastric bypass surgery are higher. Further systematic research should be conducted to precisely determine the value of the robotic EWSS for gastric bypass surgery.
The da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2014 to facilitate minimally invasive surgery. Novel features are targeted towards facilitating complex multi-quadrant procedures, but data is scarce so far. Perioperative data of patients who underwent robotic general surgery with the da Vinci Xi system within the first 6 month after installation were collected and analyzed. The gastric bypass procedures performed with the da Vinci Xi Surgical System were compared to an equal amount of the last procedures with the da Vinci Si Surgical System. Thirty-one foregut (28 Roux-en-Y gastric bypasses), 6 colorectal procedures and 1 revisional biliary procedure were performed. The mean operating room (OR) time was 221.8 (±69.0) minutes for gastric bypasses and 306.5 (±48.8) for colorectal procedures with mean docking time of 9.4 (±3.8) minutes. The gastric bypass procedure was transitioned from a hybrid to a fully robotic approach. In comparison to the last 28 gastric bypass procedures performed with the da Vinci Si Surgical System, the OR time was comparable (226.9 versus 230.6 min, p = 0.8094), but the docking time significantly longer with the da Vinci Xi Surgical System (8.5 versus 6.1 min, p = 0.0415). All colorectal procedures were performed with a single robotic docking. No intraoperative and two postoperative complications occurred. The da Vinci Xi might facilitate single-setups of totally robotic gastric bypass and colorectal surgeries. However, further comparable research is needed to clearly determine the significance of this latest version of the da Vinci Surgical System.
The average cost for robotic gastric bypass surgery fell well below the average reimbursement within the Swiss DRG system between 2012 and 2014, and this robotic procedure was a DRG winner for that period. However, the Swiss DRG system has matured over the years with a significant decrease resulting in a deficit for robotic gastric bypass surgery in 2015. This stipulates a discussion as to how health care providers should continue offering robotic gastric bypass surgery, particularly in the light of developing clinical evidence.
Obesity is one of the most diseases that considers as a global health problem, with a prevalence of >20% among the adult population in Western countries and >30% in the USA.1,2 The incidence of overweight and obesity has increased and it has been identified as an epidemic associated with an increase in the diseases related to obesity, such as coronary heart disease, type 2 diabetes, hypertension, dyslipidemia, stroke, obstructive sleep apnea, osteoarthritis and polycystic ovary syndrome. Recent a lot of studies on cancer prevention found that increased body weight was associated with an increased death rate for all cancers combined and for cancers at multiple specific sites. Thus, high body mass index (BMI) is a risk factor for higher overall mortality. Clinicians all over the world have long been aware of the impact of obesity on health, functioning and well-being. In search of effective solutions, morbidly obese patients are increasingly turning to bariatric surgery.There are a lot of bariatric surgeries to achieve the desirable weight loss but the restrictive procedures are more popular as Gastric banding (GB). It is characterized by minimal invasivity, total possibility of reversibility and good weight loss at long-term. On the other hand, Sleeve gastrectomy (SG), described by Hess and Marceau since 1988 during the procedure of duodenal switch and since 1993 by Johnston in an isolated form, is a less common restrictive operation for obesity, with major invasivity and a longer learning curve than GB. Classification of Obesity Materials and MethodsA literature search was performed using search engine Google, HighWire Press, Springer Link The following search term was used: morbid obesity, laparoscopic gastric banding, sleeve gastrectomy, outcome, effect on BMI, complication. Surgical TechniqueLaparoscopic Gastric banding (GB) Described in 1993 by Catona, is a surgical option that involves placing a silicone band circumferentially around the uppermost aspect of the stomach. The band creates a small proximal pouch that empties slowly resulting in early satiety and a decreased appetite. The band is attached to an access port that is secured to the rectus muscle and can be accessed percutaneously in the office with a needle. Injection of saline into the port results in tightening of the band. This is performed on an individual basis according to weight loss and appetite. It is the most popular in Europe while in USA it has been approved by FDA in 2001. Sleeve Gastrectomy (SG) described by Hess and Marceau since 1988 during the procedure of duodenal switch and since 1993 by Johnston in an isolated form, consists of vertical gastric resection of 80% capacity with exeresis of the fundus and body of the stomach linearly from the Hiss angle to 3-4 cm from the pylorus using Endo GIA staplers, which leaves a gastric residual volume ranging from 50 ml to 200 ml. However, as yet, there is no agreement on the optimum residual volume. Effect of Surgery on WeightStudies showed that both SG and GB have achieved a go...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.