Laparoscopic gastric bypass performed with the Da Vinci Intuitive Robotic System: preliminary experience.
BACKGROUND
This study aimed to analyze retrospectively the authors' preliminary experience using the Da Vinci Intuitive Robotic System for gastric bypass in managing morbid obesity, and to determine its efficacy and safety in relation to other standardized laparoscopic surgical techniques.


METHODS
From October 2000 to March 2004 the authors performed 146 laparoscopic gastric bypasses, 17 of which were robot assisted using the Da Vinci Intuitive Robotic System. The last patients were 7 men and 10 women with a mean age of 44 years. The mean weight was 139 kg, and the mean body mass index (BMI) was 49.8 kg/m at first postoperative recovery. The mean excess body weight (EBW) was 131%. Follow-up assessment, performed at months 1, 3, 6, and 12, then yearly thereafter, included evaluation of the variations in BMI and the percentage of excess body weight loss (EBWL%). All the patients were informed of the risks inherent with each surgical procedure as well as the potential benefits.


RESULTS
The mean operative time was 201 min (range, 90-300 min). No intraoperative complications and no conversion occurred in this series. The mean hospital stay was 9 days (range, 6-18 days). The patients in this series experienced a normal postoperative course without anastomotic complications. The mortality rate was zero. No robot-related complications were noted. The analysis of follow-up assessment at months 1, 3, 6, and 12 showed a progressive decrease in BMI and an increment of EBWL%.


CONCLUSIONS
The authors' early experience with robotic surgery suggests that it is safe and could be an effective alternative to conventional laparoscopic surgery. The authors believe that robotic surgery, with its ability to restore the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, could allow complex procedures to be performed with greater precision and better results.
Parini
U
U
Department of General Surgery, Valle d'Aosta Regional Hospital, Viale Ginevra 3, 11100 Aosta, Italy.
Fabozzi
M
M
Brachet Contul
R
R
Millo
P
P
Loffredo
A
A
Allieta
R
R
Nardi
M
M
Lale-Murix
E
E
D000328:Adult; D015992:Body Mass Index; D004867:Equipment Design; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000295:instrumentation*; D016896:Treatment Outcome