Skip to main content
Springer Nature Link
Log in

Robot-Assisted Versus Laparoscopic Gastric Bypass: Comparison of Short-Term Outcomes

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567–76.

    Article  PubMed  CAS  Google Scholar 

  2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  3. Mason EE, Ito C. Gastric bypass. Ann Surg. 1969;170:329–39.

    Article  PubMed  CAS  Google Scholar 

  4. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:353–7.

    Article  PubMed  Google Scholar 

  5. Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11:415–9.

    Article  PubMed  CAS  Google Scholar 

  6. Yu SC, Clapp BL, Lee MJ, et al. Robotic assistance provides excellent outcomes during the learning curve for laparoscopic Roux en-Y gastric bypass: results from 100 robot assisted gastric bypasses. Am J Surg. 2006;192:746–9.

    Article  PubMed  Google Scholar 

  7. Snyder BE, Wilson T, Leong BY, et al. Robotic-assisted Roux-en-Y gastric bypass: minimizing morbidity and mortality. Obes Surg. 2010;20:265–70.

    Article  PubMed  Google Scholar 

  8. Deng JY, Lourié DJ. 100 robotic-assisted laparoscopic gastric bypasses at a community hospital. Am Surg. 2008;10:1022–5.

    Google Scholar 

  9. Scozzari G, Rebecchi F, Millo P, et al. Robotic-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2011;25:597–603.

    Article  PubMed  Google Scholar 

  10. Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg. 2004;188(4A supp):38–44S.

    Article  Google Scholar 

  11. Schauer P, Ikramuddin S, Hamad G, et al. The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc. 2003;17:2012–5.

    Article  Google Scholar 

  12. Aloo SM, Addeo P, Shah G, et al. Robot-assisted hybrid laparoscopic Roux-en-Y gastric bypass: surgical technique and early outcomes. J Laparosc Adv Surg Tech A. 2010;20:847–50.

    Article  Google Scholar 

  13. Mohr CJ, Nadzam GS, Alami RS, et al. Totally robotic laparoscopic Roux-en-Y gastric bypass: results from 75 patients. Obes Surg. 2006;16:690–6.

    Article  PubMed  Google Scholar 

  14. Podnos YD, Jimenez JC, Wilson SE, et al. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg. 2003;138:957–61.

    Article  PubMed  Google Scholar 

  15. Nguyen NT, Rivers R, Wolfe BM. Early gastrointestinal hemorrhage after laparoscopic gastric bypass. Obes Surg. 2003; 13:466–467.

    Google Scholar 

  16. Mehran A, Szomstein SN, Rosenthal R. Management of acute bleeding after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13:842–7.

    Article  PubMed  Google Scholar 

  17. Dick A, Byrne TK, Baker M, et al. Gastrointestinal bleeding after gastric bypass surgery: nuisance or catastrophe? Surg Obes Relat Dis. 2010;6:643–7.

    Article  PubMed  Google Scholar 

  18. Nyugen NT, Longoria M, Chalifoux S, et al. Gastrointestinal hemorrhage after laparoscopic gastric bypass. Obes Surg. 2004;14:1308–12.

    Article  Google Scholar 

  19. Dillemans B, Sakran N, Van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19:1355–64.

    Article  PubMed  Google Scholar 

  20. Bellorin O, Abdemur A, Sucandy I, et al. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg. 2011;21:707–13.

    Article  PubMed  Google Scholar 

  21. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.

    Article  PubMed  CAS  Google Scholar 

  22. Abeles D, Kim JJ, Tarnoff ME. Primary laparoscopic gastric bypass can be performed safely in persons with BMI > or = 60. J Am Coll Surg. 2009;208:236–40.

    Article  PubMed  Google Scholar 

  23. Rabl C, Peeva S, Prado K, et al. Early and late abdominal bleeding after Roux-en-Y gastric bypass: sources and tailored therapeutic strategies. Obes Surg. 2011;21:413–20.

    Article  PubMed  Google Scholar 

  24. Bakhos C, Alkhoury F, Kyriakides T. Early postoperative hemorrhage after open and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;19:153–7.

    Article  PubMed  Google Scholar 

  25. Nguyen NT, Dakin G, Needleman B, et al. Effect of staple height on gastrojejunostomy during laparoscopic gastric bypass: a multicenter prospective randomized trial. Surg Obes Relat Dis. 2010;6:477–82.

    Article  PubMed  Google Scholar 

  26. Oliak D, Ballantyne GH, Weber P, et al. Laparoscopic Roux-en-Y gastric bypass: defining the learning curve. Surg Endosc. 2003;17(3):405–8.

    Article  PubMed  CAS  Google Scholar 

  27. Higa KD, Boone KB, Ho T, et al. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000;135:1029–33.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Janet L. Tremaine, ELS, Tremaine Medical Communications, Inc., Dublin, OH, for editorial assistance.

Disclosures

Stephan R. Myers, MD, has received payment for proctoring other surgeons on the da Vinci robot and for speaking for Intuitive Surgical.

John McGuirl, PhD, and Jillian Wang, BS, have no conflict of interest.

Author information

Authors and Affiliations

  1. The Reading Hospital and Medical Center, Sixth Avenue and Spruce Street, P.O. Box 16052, West Reading, PA, 19611, USA

    Stephan R. Myers

  2. Cognitive Systems Analytics, Columbus, OH, USA

    John McGuirl

  3. The Ohio State University, Columbus, OH, USA

    Jillian Wang

Authors
  1. Stephan R. Myers
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. John McGuirl
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Jillian Wang
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Stephan R. Myers.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Myers, S.R., McGuirl, J. & Wang, J. Robot-Assisted Versus Laparoscopic Gastric Bypass: Comparison of Short-Term Outcomes. OBES SURG 23, 467–473 (2013). https://doi.org/10.1007/s11695-012-0848-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-012-0848-0

Keywords