Perioperative Outcomes of Robotic Versus Laparoscopic Sleeve Gastrectomy in the Super-obese

Nasser, Hassan; Ivanics, Tommy; Ranjal, Rohit Shenoy; Leonard-Murali, Shravan; Genaw, Jeffrey A.

doi:10.1016/j.jss.2019.12.012

Cited by 14 publications

(7 citation statements)

References 42 publications

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“…Nevertheless, many articles showed that RA-LSG is related to increased supply cost, 163,164 operative time, and postoperative morbidity. 165,166 ESG seems to be promising. ESG is a minimally invasive procedure that reduces the size of the gastric reservoir and appears to be well tolerated, safe, and effective 167,168 with fewer adverse events and newonset GERD cases than LSG.…”

Section: Discussionmentioning

confidence: 99%

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Li¹,

Jiao²,

Zhang³

et al. 2021

DMSO

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Bariatric surgery has become increasingly common due to the worldwide obesity epidemic. A shift from open to laparoscopic surgery, specifically, laparoscopic sleeve gastrectomy (LSG), has occurred in the last two decades because of the low morbidity and mortality rates of LSG. Although LSG is a promising treatment option for patients with morbid obesity due to restrictive and endocrine mechanisms, it requires modifications for a subset of patients because of weight regain and tough complications, such as gastroesophageal reflux, strictures, gastric leak, and persistent metabolic syndrome., Revision surgeries have become more and more indispensable in bariatric surgery, accounting for 7.4% in 2016. Mainstream revisional bariatric surgeries after LSG include Roux-en-Y gastric bypass, repeated sleeve gastrectomy, biliopancreatic diversion, duodenal switch, duodenal-jejunal bypass, one-anastomosis gastric bypass, single anastomosis duodeno-ileal bypass (SAID) and transit bipartition. This review mainly describes the revisional surgeries of LSG, including the indication, choice of surgical method, and subsequent effect.

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Section: Discussionmentioning

confidence: 99%

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Li¹,

Jiao²,

Zhang³

et al. 2021

DMSO

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“…17 Los defectos del abordaje de laparoscopía en pacientes con obesidad grado III o superobesidad conducen a un procedimiento técnicamente más desafiante como resultado de la pared abdominal más gruesa, la mayor cantidad de grasa visceral en la cavidad abdominal y el hígado graso que disminuyen el espacio de trabajo. 14 Las ventajas de la cirugía robótica sobre la laparoscopía tradicional incluyen imágenes tridimensionales, escala de movimiento y filtración de temblores, mejorando así la destreza y precisión, siete grados de libertad y una ergonomía mejorada. 18,14 En la mayoría de otras comparaciones entre el abordaje robótico y laparoscópico se ha observado un aumento del tiempo operatorio con el enfoque robótico, incluido un pequeño estudio centrado en pacientes superobesos.…”

Section: Discussionunclassified

“…14 Las ventajas de la cirugía robótica sobre la laparoscopía tradicional incluyen imágenes tridimensionales, escala de movimiento y filtración de temblores, mejorando así la destreza y precisión, siete grados de libertad y una ergonomía mejorada. 18,14 En la mayoría de otras comparaciones entre el abordaje robótico y laparoscópico se ha observado un aumento del tiempo operatorio con el enfoque robótico, incluido un pequeño estudio centrado en pacientes superobesos. El aumento en el tiempo operatorio está relacionado con el atraque y el desacoplamiento, además de ser altamente dependiente de la experiencia del cirujano y del personal operativo.…”

Section: Discussionunclassified

“…[11][12][13] Recientemente se ha observado que pacientes con un índice de masa corporal (IMC), ≥ 50 kg/m 2 (superobesos, (SO)) presentan desafíos particulares relacionados tanto con la cirugía como con la anestesia debido a las comorbilidades y características corporales, es así que los procedimientos bariátricos laparoscópicos son en general seguros y efectivos en estos pacientes, pero están asociados con mayor morbilidad y mortalidad a 30 días. 14 La cirugía laparoscópica en pacientes con SO es técnicamente más difícil como resultado del aumento del grosor de la pared abdominal, el torque excesivo del instrumento, la gran cantidad de grasa periférica y el espacio de trabajo limitado. Los enfoques asistidos por robot tienen el potencial para aliviar varios de estos desafíos y, por lo tanto, son particularmente útiles en casos en los que la laparoscopía tiene deficiencias.…”

Section: Introductionunclassified

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Gastrectomía en manga robótica y laparoscópica: Resultados tempranos de un estudio en población mexicana

Fuentes¹,

Fuentes²,

Ventura³

et al. 2020

Revista Mexicana De Cirugía Endoscópica

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La gastrectomía en manga ha ganado popularidad durante la última década debido a su seguridad, viabilidad y buenos resultados. El propósito de este estudio es describir nuestros resultados a corto plazo con estos procedimientos. Material y métodos: Este estudio es una revisión retrospectiva no aleatorizada de 36 pacientes que se sometieron a una gastrectomía en manga de mínimo acceso en el Centro Médico Nacional 20 de Noviembre de enero de 2015 a diciembre de 2018. Un total de 18 pacientes se sometieron a una gastrectomía en manga laparoscópica y otros 18 pacientes se sometieron a un procedimiento robótico utilizando el Da Vinci Surgical System ® . Se revisaron los datos demográficos de los pacientes, las comorbilidades, la fecha de la cirugía, la morbilidad y mortalidad posoperatorias, el tiempo operatorio y la duración de estancia intrahospitalaria. Resultados: La edad media fue 49.28 ± 7.62 (GM-R) frente a 48.83 ± 6.8 (GM-L) sin diferencia estadística entre los dos grupos. La demografía de los pacientes fue similar en ambos grupos. El tiempo quirúrgico medio para el grupo robótico fue 79.11 ± 9.54 frente a 75.05 ± 8.67 min en el grupo laparoscópico, sin diferencia estadística. No hubo diferencias significativas entre los dos ABSTRACT Introduction: Sleeve gastrectomy has gained popularity over the past decade due to its safety, feasibility, and good results. The purpose of this study is to describe our results, short term, with these procedures. Material and methods:This study is a nonrandomized, retrospective review of 36 patients who underwent a minimally invasive sleeve gastrectomy at the National Medical Center 20 de Noviembre from January 2015 to December 2018. A total of 18 patients underwent a laparoscopic sleeve gastrectomy, and another 18 patients underwent a robotic procedure using the da Vinci Surgical System ® . Patient demographics, comorbidities, date of surgery, postoperative morbidity and mortality, operating time, and length of stay were reviewed. Results: The mean age was with no statistical difference between the two groups. Patient's demographics were similar in both groups. The mean operative time for the robotic group was 79.11 ± 9.54 versus 75.05 ± 8.67 min in the laparoscopic group, with no statistical difference. There were no significant differences between the two groups with regard to the perioperative complications, length of stay. Conclusion: There is no significant difference between the robotic

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“…Generally, patients with BMI >50 kg/m 2 are high-risk candidates for surgery and face a higher rate of postoperative complications when compared with lower BMI subgroups 6,7. Several studies using the MBSAQIP large datasets show significantly higher rates of short-term complications in patients with severe obesity compared with all patients 8,9. While there are numerous studies comparing patients with severe obesity to patients with morbid obesity (BMI <50 kg/m 2 ), there is limited evidence correlating increasing BMI beyond 50 kg/m 2 to surgical efficacy and safety.…”

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confidence: 99%

Does BMI Matter? A 10-Year Single Institutional Experience on 571 Bariatric Surgery Patients With BMI >50 kg/m2

Badaoui¹,

Maroun²,

Oyefule³

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction: Patients undergoing bariatric surgery with body mass index (BMI) >50 kg/m2 are at a higher risk of surgical morbidity when compared with less obese patients, however, there is limited data correlating surgical risk and efficacy with increasing BMI in patients with severe obesity. We hypothesize that regardless of the degree above 50 kg/m2 their BMI, patients with severe obesity respond similarly to bariatric surgery. Materials and Methods: We performed a retrospective analysis of patients with BMI >50 kg/m2 who underwent biliopancreatic diversion with duodenal switch, Roux-en-Y gastric bypass, or sleeve gastrectomy at a single institution. Outcomes were compared in patients with a BMI between 50 and 60 kg/m2 to patients with a BMI >60 kg/m2 and included percent total weight loss as well as early and late complications. Statistical analyses were performed using logistic regression, univariate, and multivariate models. Results: There were 571 patients with BMI >50 kg/m2 who underwent bariatric surgery at our center, 170 (29.8%) had a BMI >60 kg/m2. Percent total weight loss was statistically significant between the BMI 50 and 60 kg/m2 and BMI >60 kg/m2 groups at 24 months (P=0.047) but not at 60 months (P=0.54). No significant difference was found in the incidence of early complications in a univariate (P=0.46) or a multivariate (P=0.06) analysis. The BMI >60 subgroup was associated with a higher rate of late complications in univariate analysis (heart rate=2.37; 1.03-5.47, P=0.04), but not in multivariate analysis (P=0.78). Conclusions: Efficacy and complication rates of bariatric surgeries are similar in patients with BMI 50 to 60 kg/m2 and >60 kg/m2, providing evidence supporting similar management of patients despite specific subgroups.

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Perioperative Outcomes of Robotic Versus Laparoscopic Sleeve Gastrectomy in the Super-obese

Cited by 14 publications

References 42 publications

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Gastrectomía en manga robótica y laparoscópica: Resultados tempranos de un estudio en población mexicana

Does BMI Matter? A 10-Year Single Institutional Experience on 571 Bariatric Surgery Patients With BMI >50 kg/m2

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