title: Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes.
abstract: BACKGROUND
  Roux-en-Y gastric bypass is an effective treatment for severe obesity and obesity-related comorbidities. Presently, gastric bypass is performed most often laparoscopically, although a robotic-assisted procedure is the preferred approach for an increasing number of bariatric surgeons.
  
  
  METHODS
  This retrospective study compared the results of 100 Roux-en-Y gastric bypass operations using the da Vinci robot and 100 laparoscopic Roux-en-Y gastric bypasses performed laparoscopically. Short-term outcomes were determined by evaluating mortality, length of stay, length of operation, return to the operating room within 90 days of operation, conversions to open procedure, leaks, strictures, transfusions, and hospital readmissions.
  
  
  RESULTS
  There was no mortality, pulmonary embolus, or conversion to open procedure in either group. Both the laparoscopic and robotic operative times decreased progressively, although the robotic operation time was longer (mean, 144 versus 87 min, P < 0.001). The length of stay was shorter for the robotic-assisted group (37 versus 52 h, P < 0.001), and 60% of these patients were discharged after one night's stay (P < 0.001). There were fewer transfusions (P = 0.005) and readmissions (P = .560) in the robotic group. The stricture rate was higher in the first 50 robotic procedures (17 mm gastrotomy) but resolved in the second 50 procedures (21 mm gastrotomy). There was no difference in the rate of leak and return to the operating room between groups (both P > 0.05).
  
  
  CONCLUSIONS
  These results indicate that Roux-en-Y gastric bypass can be performed safely with robotic assistance, even during the first 100 cases.
authors: The Reading Hospital and Medical Center, Sixth Avenue and Spruce Street, P.O. Box 16052, West Reading, PA 19611, USA. drstevemyers@gmail.com
authors: Stephan R
authors: SR
authors: Myers
authors: John
authors: J
authors: McGuirl
authors: Jillian
authors: J
authors: Wang
mesh_terms: D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D015390:Gastric Bypass / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome; D015431:Weight Loss