Robotic-Assisted Roux-en-Y Gastric Bypass: Minimizing Morbidity and Mortality

Department of Surgery, University of Texas Health Sciences Center at Houston, 6431 Fannin Street, Suite 4.294, Houston, TX, 77030, USA.
Obesity Surgery (Impact Factor: 3.75). 11/2009; 20(3):265-70. DOI: 10.1007/s11695-009-0012-7
Source: PubMed


Despite the rapid acceptance of laparoscopic Roux-en-Y gastric bypass (RYGB) by the community and increase in the number of these procedures being done, there is still significant morbidity and mortality.
At the University of Texas Medical School at Houston, we have performed 320 RYGB with robotic assistance (RARYGB). Surgical times, length of stay, morbidity, and mortality have been recorded since the beginning of our robotic experience and represent the world's largest single institution series of RARYGB. Outcome data were examined in a postoperative cohort.
The average starting BMI was 49.1 kg/m(2), and it declined by 66% to 32.5 kg/m(2) by the end of 1 year. The average operative time was 192 min, and the average length of stay was 2.7 days. Within the first year, there were a total of 77 (24.1%) complications. The foremost complications noted in the literature to be 3% to 11% were all <1% in our series, and we have no mortalities. Compared to our 356 laparoscopic RYGB, there was a significantly lower gastrointestinal leak rate in the robotic arm. A cohort of 79 postoperative patients was analyzed with respect to weight loss, resolution of co-morbidity, and quality of life. While there was no variation in quality of life over time, weight loss, resolution of co-morbidities, and overall outcome score were significantly improved.
We effectively perform robotic-assisted RYGB that lowers the morbidity and mortality of this procedure compared to today's standard while maintaining thriving outcomes.

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    • "In conclusion, the robotic approach to gastric bypass provides results similar (feasibility, morbidity) to those obtained by conventional laparoscopy. One study even shows a decreased risk of leakage of the gastrojejunal anastomosis [66]. This point remains to be confirmed by studies with a good level of evidence (I or II) [25]. "

    Journal of Visceral Surgery 10/2011; 148(5 Suppl):e47-53. DOI:10.1016/j.jviscsurg.2011.05.006 · 1.75 Impact Factor
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    • "Weight loss after robotic surgery is similar to that obtained in open or conventional laparoscopic surgery. However, morbidity and notably the risk of gastrojejunostomy leak may be reduced with robotic surgery [1] "

    Journal of Visceral Surgery 06/2011; 148(4):e267-72. DOI:10.1016/j.jviscsurg.2011.05.003 · 1.75 Impact Factor
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    ABSTRACT: The da VinciTM robotic system (Intuitive Surgical, Inc, Sunnyvale, CA) has been used frequently for urological procedures including radical prostatectomy and pyeloplasty. Its use in bariatric surgery is limited to few high volume centres in the western world. The advantages of robotic assistance are three-dimensional vision, ergonomic advantage and improved precision. We report our experience of using this advanced technology to perform a robotic Roux-en-Y gastric bypass in a 55-year-old obese diabetic patient. We were able to reproduce our standard laparoscopic technique and all the steps of the surgical procedure were done using robotic assistance.
    Indian Journal of Surgery 01/2013; 77(2). DOI:10.1007/s12262-013-0948-7 · 0.26 Impact Factor
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