title: Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital.
abstract: The purpose of this study was to compare the operative and early perioperative outcomes of laparoscopic versus robotic-assisted Roux-en-Y gastric bypass procedures performed in a community hospital setting.
  
  
  
  The study was a chart review and analysis of the early perioperative outcomes of a total of 345 Roux-en-Y gastric bypass procedures performed by a single surgeon in a community hospital setting from January 2011 to October 2014. Of these, 173 procedures were performed laparoscopically and 172 were performed with robotic assistance utilizing the daVinci(®) surgical platform. Factors such as baseline patient characteristics, operative time, estimated blood loss (EBL), conversions to open procedure, complication rates, adverse events, length of stay (LOS), and return to the operating room for the two groups were retrospectively analyzed from a prospectively maintained database. Student's t test with unequal variances was used for statistical analysis, and a p value <0.05 was used for significance.
  
  
  
  There were no statistically significant differences in complication rates, EBL, or LOS between the two groups. There was a significant difference between the total operative times (135.30 ± 37.60 min for the laparoscopic procedure versus 154.84 ± 38.44 min for the robotic procedure, p < 0.05). There were no adverse intraoperative events, conversions to open procedures, leaks, strictures, returns to the operating room within 30 days, or mortalities in either group.
  
  
  
  Our study, which is the first of its kind to analyze the operative and early perioperative outcomes between laparoscopic and robotic-assisted Roux-en-Y gastric bypass procedures in the US community hospital setting, indicates that both are comparable in terms of safety, efficacy, and operative and early perioperative outcomes.
authors.affiliation: Department of General and Bariatric Surgery, John T. Mather Memorial Hospital, Port Jefferson, NY, USA. aahmadmd@aol.com.|Department of General and Bariatric Surgery, St. Charles Hospital, Port Jefferson, NY, USA. aahmadmd@aol.com.|Division of General and Bariatric Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA. aahmadmd@aol.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of General and Bariatric Surgery, John T. Mather Memorial Hospital, Port Jefferson, NY, USA.
authors.forename: Jared D
authors.initials: JD
authors.lastname: Carleton
authors.affiliation: Department of General and Bariatric Surgery, John T. Mather Memorial Hospital, Port Jefferson, NY, USA.
authors.forename: Zoha F
authors.initials: ZF
authors.lastname: Ahmad
authors.affiliation: Department of General and Bariatric Surgery, John T. Mather Memorial Hospital, Port Jefferson, NY, USA.|Department of General and Bariatric Surgery, St. Charles Hospital, Port Jefferson, NY, USA.|Division of General and Bariatric Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Agarwala
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000379:methods* / Q000401:mortality; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D055815:Young Adult
keywords: Bariatric surgery; Community hospital; Laparoscopic; Morbid obesity; Robotics; Roux-en-Y gastric bypass