Robotic-assisted Roux-en-Y Gastric bypass: minimizing morbidity and mortality.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
We effectively perform robotic-assisted RYGB that lowers the morbidity and mortality of this procedure compared to today's standard while maintaining thriving outcomes.
Snyder
Brad Elliott
BE
Department of Surgery, University of Texas Health Sciences Center at Houston, 6431 Fannin Street, Suite 4.294, Houston, TX, 77030, USA. brad.snyder@uth.tmc.edu
Wilson
Todd
T
Leong
Benjamin Y
BY
Klein
Connie
C
Wilson
Erik B
EB
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D015390:Gastric Bypass / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012371:Robotics; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*