Risk Factors for Postoperative Morbidity After Totally Robotic Gastric Bypass in 302 Consecutive Patients

Fantola, Giovanni; Nguyen-Thi, Phi-Linh; Reibel, N.; Sirveaux, Marie-Aude; Germain, A; Ayav, Ahmet; Bresler, L.; Zarnegar, Rasa; Brunaud, Laurent

doi:10.1007/s11695-014-1530-5

Cited by 10 publications

(3 citation statements)

References 50 publications

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“…In this study, the 60-day major complication rate (Clavien-Dindo score 3 or 4) and reoperation rate were 12.2% and 10.2%, respectively. Fourteen patients (4.6%) had a postoperative anastomotic leak requiring specific surgical management ( 24 ).…”

Section: Primary Proceduresmentioning

confidence: 99%

Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience

et al. 2022

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Laparoscopy is the surgical standard of care for bariatric procedures; however, during the last two decades, the robotic approach has gained increasing interest. It is currently considered a safe and effective alternative to laparoscopy. This literature review investigates the role of the robotic approach for primary and revisional bariatric procedures, with the particular aim of comparing this technique with the standard-of-care laparoscopic approach. The feasibility of robotic dissection and suturing could have potential advantages: robotics may prevent the risk of leak and bleeding and other surgical complications, determining potential benefits in terms of operative time, length of hospital stay, and learning curve. Considering primary procedures, the literature reveals no advantages in robotic versus the laparoscopic approach for adjustable gastric banding and sleeve gastrectomy. Robotic Roux-en-Y gastric bypass is associated with a longer operative time and a shorter hospital length of stay than laparoscopy. The robotic approach in revisional surgery has been proven to be safe and effective. Despite the longer operative time, the robotic platform could achieve a lower bleeding rate compared with laparoscopy. The surgeon’s selection criteria related to referrals to the robotic approach of difficult-perceived cases could represent a bias. In conclusion, robotic surgery can be considered a safe and effective approach in both primary and revisional bariatric surgery, despite the lack of evidence to support its routine use in primary bariatric surgery. However, in revisional bariatric surgery and in surgical complex procedures, the robotic approach could have potential benefits in terms of surgical complications and learning curves.

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Section: Primary Proceduresmentioning

confidence: 99%

Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience

et al. 2022

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“…Arguably, the risk spreads towards continuing professional development too, as it is recognised that educational programmes for the wider surgical robotics teams are urgently needed and that most conferences and courses in this fast-changing area are only available for surgeons (Raheem et al 2017). Finally, RAS requires crucial coordination between the operating surgeon and the BA (Fantola et al 2014, Thiel et al 2013) and the appropriate training of the latter professionals may be essential to further improve perioperative patients’ outcomes (Sessa et al 2018).…”

Section: Introductionmentioning

confidence: 99%

The role of the bedside assistant in robot-assisted surgery: A critical synthesis

Britton

Francis

Tay

et al. 2022

Journal of Perioperative Practice

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Introduction: Robot-assisted surgery has grown exponentially since its inception and first approval in the United States in the year 2000. The surgeon operating with the assistance of the robot sits remotely to the patient and another practitioner assists at the bedside. The role of the bedside assistant and the training that is required to undertake this role are understudied topics. Aim: To explore the functions, training and professional development of the bedside assistant in robot-assisted surgery and propose the necessary foundations for the safe enactment of the role in the United Kingdom. Methods: Through critical interpretative synthesis, relevant literature was systematically searched and analysed to inform integration of evidence. Results: Seventy-three studies were retrieved from the literature, across several health care disciplines and surgical specialities. These were critically analysed to inform a theoretically sound account grounded on evidence. Conclusion: The role, functions and skills of the bedside assistant in robot-assisted surgery vary across contexts. These were analysed and critically synthetised to produce several keys to the success of bedside assistants in robot-assisted surgery in the context of the United Kingdom and of its national regulations.

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“…In 2015, a retrospective analysis of over 300 patients demonstrated low preoperative hematocrit was found to be a risk factor for 60-day postoperative major morbidity after robotassisted RYGB. 17 Since the release of the annual MBSAQIP PUF, hematocrit has scarcely been acknowledged as a risk factor for 30-day morbidity and mortality in the various contexts of studies which have thus far been reported. It was this important gap in knowledge that provided the impetus to investigate whether preoperative anemia influences short-term morbidity and mortality after bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass

Wise

Beckman

Amateau

et al. 2021

The American Surgeon

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Background Preoperative anemia has been suggested as a contraindication to gastric bypass. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement database, this study sought to determine the role of preoperative hematocrit on 30-day morbidity and mortality after laparoscopic Roux-en-Y gastric bypass for weight loss. Methods A cohort of 31 981 patients was reviewed for factors associated with a composite primary end point including 30-day reoperation, readmission, reintervention, or mortality, including degree of anemia. Analyzed separately by gender, factors significant on bivariate analysis were included in nominal logistic multivariate analysis to assess for independent significance of the hematocrit level as a risk factor for the primary end point. Results Upon multivariate analysis, the hematocrit level was significantly associated with the 30-day end point in the male cohort ( P = .05), specifically, severe anemia (hematocrit <35%) conferred an increased risk relative to a normal hematocrit (odds ratio 1.5, P = .03). There was no association of hematocrit with the 30-day end point in the female cohort. Conclusion Bariatricians should carefully consider the appropriateness of a gastric bypass over a less anemogenic procedure such as sleeve gastrectomy in patients, particularly men with preoperative anemia.

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Risk Factors for Postoperative Morbidity After Totally Robotic Gastric Bypass in 302 Consecutive Patients

Abstract: R-RYGBP is prone to increased complications in the setting of a high preoperative ASA score and revisional surgery. This should be taken into consideration by clinicians when evaluating R-RYGBP.

Cited by 10 publications

References 50 publications

Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience

Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience

The role of the bedside assistant in robot-assisted surgery: A critical synthesis

The Role of Preoperative Anemia in Predicting Short-Term Morbidity and Mortality After Roux-en-Y Gastric Bypass

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