Technique evolution, learning curve, and outcomes of 200 robot-assisted gastric bypass procedures: a 5-year experience.
BACKGROUND
We evaluate our 5-year experience, evolution of technique, and clinical outcomes with robot-assisted RYGB.


METHODS
Two hundred consecutive patients who underwent robot-assisted RYGB at our center were included. Among them, 118 patients underwent a hybrid robot-assisted laparoscopic RYGB (LRRYGB), and 82 patients underwent a totally robotic RYGB (TRRYGB). Patient demographics, clinical characteristics, comorbidities, operative parameters, conversions, morbidity, mortality, and excess weight loss were analyzed.


RESULTS
Most of the patients (88 %) were female with a mean age of 41.9 years and mean BMI of 46.6 kg/m(2). The outcomes of patients who underwent LRRYGB (n = 118) were compared to those who underwent TRRYGB (n = 82). The mean operative time in TRRYGB group was 170.9 ± 51.4 min which was significantly lower than LRRYGB group (216 ± 54.1 min). The mean operative time for the last 100 patients was significantly lower than that for the first 100 patients. The excess weight loss (EWL) was 58.3 % at 6 months, 67.7 % at 1 year, 71.6 % at 2 years, and 65 % at 3 years. There were three conversions to open, three reoperations and four readmissions. There were no anastomotic leak, major bleed, gastrojejunostomy stricture, or mortality seen in our series.


CONCLUSIONS
Use of robot assistance to perform RYGB is safe and may reduce the associated complications, namely, anastomotic leak, gastrojejunostomy (GJ) stricture, and hemorrhage. Excess weight loss at 2 years after RRYGB is comparable to laparoscopic RYGB.
Division of General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, 840 S Wood St, Suite 435E, M/C 958, Chicago, IL, 60612, USA, bindal.vivek@gmail.com.
Vivek
V
Bindal
Raquel
R
Gonzalez-Heredia
Mario
M
Masrur
Enrique F
EF
Elli
D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007858:Learning; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012086:Reoperation; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome