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Therapeutic study, level II.

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Background Postoperative morbidity after laparoscopic bariatric surgery is considered higher for patients undergoing revisional versus primary procedures. The objective of this retrospective cohort study was to compare outcomes between patients undergoing primary versus revisional robotically assisted laparoscopic (RAL) Roux-en-Y gastric bypass (RYGB). Methods Data of all patients who underwent RAL primary and revisional RYGB between 2009 and 2019 at two accredited, high-volume bariatric surgery centers—the Memorial Hermann – Texas Medical Center, Houston, TX, and the Tower Health, Reading Hospital, Reading, PA, were analyzed. Primary outcomes were early (< 30 days) and overall postoperative complications. Secondary outcomes included intraoperative complications, operative times, conversions to laparotomy, length of hospital stay, early (< 30 days) postoperative readmissions and deaths. Results Data of 1072 patients were analyzed, including 806 primary and 266 revisional RAL RYGB procedures. Longer operative times (203 versus 154 min, P < 0.001), increased number of readmissions for oral intolerance (10.5% versus 6.7%, P = 0.046) and higher rate of gastrojejunal stricture (6.4% versus 2.7%, P = 0.013) were found in the revisional group. Gastrointestinal leak rates were 0.2% for the primary versus 1.1% for the revisional group (P = 0.101). Early (< 30 days) reoperations rates were 2.2% for the primary versus 1.1% for the revisional group (P = 0.318). There were no statistically significant differences between groups in overall and severe complication rates. Conclusion Patients undergoing RAL primary and revisional RYGB had comparable overall outcomes, with a non-significant higher early complication rate in the revisional group. Despite the study being underpowered to detect differences in specific complication rates, the morbidity seen in the revisional RYGB group remains markedly below literature reports of revisional laparoscopic RYGB and might suggest a benefit of robotic assistance. Further prospective studies are needed to confirm these results.

A B S T R A C TA new genus and species of raninid crab, Bicornisranina bocki, is described from the Upper Cretaceous Haslam and Pender formations of Vancouver Island, British Columbia, Canada. Bicornisranina bocki (Raninidae: Raninoidinae) shares similar characteristics with other genera within Raninidae, including a bifid anterolateral spine, as seen in Rogueus, and a similar frontal spine conformation as seen in Raninoides. Although B. bocki shares morphological characteristics with other genera within Raninidae, B. bocki possesses a distinct sternum that sets it apart and warrants establishment of a new genus. With the occurrence of Bicornisranina from lower Campanian rocks of Vancouver Island, the range of Raninoidinae is confidently extended into the Cretaceous.

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A new porcellanid crab, Petrolisthes landsendi Garassino & Nyborg n. sp., from the Upper Cretaceous (upper Santonian) Nanaimo Group of Vancouver Island (British Columbia, Canada) is herein described. Petrolisthes landsendi Garassino & Nyborg n. sp. represents the oldest species of Petrolisthes Stimpson, 1858 and is the first species from the northeastern Pacific, thus expanding the stratigraphical age and geographical range of the genus.