Current status of robotic bariatric surgery: A systematic review

BMC Surgery (Impact Factor: 1.4). 11/2013; 13(1):53. DOI: 10.1186/1471-2482-13-53
Source: PubMed


Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review.
A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science.
Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days).
The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy).

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    • "Since the first robotic bariatric procedure, placement of an adjustable gastric band was performed in 1998 (Cadiere et al. 1999) by using the Mona, an early version of the current da Vinci System; almost all bariatric surgical procedures have been performed to varying degrees using the robotic system. Systematic reviews had already established the safety and feasible of the robotic approach in all of them (Gill et al. 2011; Cirocchi et al. 2013). RYGB is considered in many countries the gold standard of surgical treatment of morbid obesity. "
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    ABSTRACT: Robotic surgery is an emerging and promising technology in bariatric surgery. Current studies have confirmed its feasibility and safety with a relatively short learning curve. The advantages for the surgeon are already well established with better ergonomics. The potential benefits to the patient are still being studied. Robotic surgery seems to offer more advantages for complex cases, such as super obesity and revisional surgery.
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