Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital

Abstract

Our study, which is the first of its kind to analyze the operative and early perioperative outcomes between laparoscopic and robotic-assisted Roux-en-Y gastric bypass procedures in the US community hospital setting, indicates that both are comparable in terms of safety, efficacy, and operative and early perioperative outcomes.

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

“…The operation times for RRYGB were significantly shorter than LRYGB, despite inclusion of the first procedures using the da Vinci Xi system. In contrast to our data, most studies report a longer operative time when using the robot [11,15,16,[21][22][23]29]. However, the operative time varies considerably between these publications, decreasing from a high of 245 min [13] to 108 min [16].…”

“…Whether these statements are also valid for RRYGB remains to be shown. While most workgroups opted for a robotic hand-sewn anastomosis [8,11,12,[15][16][17][18][19]33], we kept to the well-established technique using the linear stapler. We decided to use an external linear stapler operated by the assistant.…”

“…The first robot-assisted Roux-en-Y gastric bypass (RRYGB) followed in 2001 [10]. Since then, various studies have shown that RRYGB is safe and efficient but requires longer operating times and higher costs than laparoscopic RYGB (LRYGB) [11,12]. Other studies reported lower complication rates, a lower number of revision procedures, and a steeper learning curve with RRYGB [8,[13][14][15][16][17], although some studies reported higher complication rates [18][19][20].…”

Robotic bariatric surgery: A general review of the current status

“…Overall, although only limited data in terms of quality and quantity are currently available, it seems that robotically hand‐sewn anastomoses appear to compare favorably with the laparoscopically stapled technique in terms of leak rates . Nevertheless, several studies found higher leak rates for the robotic approach compared with the conventional laparoscopy, others found comparable leak rates in both groups . Moon et al reported leakage rates of 7.8% in 64 robotic consecutive cases compared to 0.5% in 206 laparoscopic cases .…”

“…The two largest published series including both a robotic experience of more than 300 cases reported a significantly lower leak rate in the handsewn robotic group compared with the stapled laparoscopic group . Nevertheless, several comparative series didn't confirm a better outcome for the robotic approach with comparable 30‐day results in terms of safety, efficacy and early postoperative outcomes . Some found even higher leak rates for the robotic technique …”