Robotic-Assisted Surgery Results in a Shorter Hospital Stay Following Revisional Bariatric Surgery
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ORIGINAL CONTRIBUTIONS
Robotic-Assisted Surgery Results in a Shorter Hospital Stay Following Revisional Bariatric Surgery Keith King 1,2 & Alvaro Galvez 1 & Jill Stoltzfus 1,3 & Leonardo Claros 1,3 & Maher El Chaar 1,3,4 Received: 27 May 2020 / Revised: 28 September 2020 / Accepted: 5 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Revisional surgery is rapidly growing within the field of bariatric surgery. The use of robotic assisted surgery, considered controversial by many, may offer advantages in revisional bariatric surgery (RBS). There are few studies comparing laparoscopic and robotic-assisted RBS. The aim of this study is to compare the safety and outcome of laparoscopic and robotic RBS in a single accredited center. Methods A retrospective analysis of data collected prospectively on patients undergoing either laparoscopic (L-RBS) or robotic (R-RBS) RBS between January 1, 2017 and December 31, 2019 was performed. The primary outcomes included length of stay (LOS), 30-day major and minor complication rates, readmission rates, and mortality rates. Results A total of 167 patients were included in our analysis. Fifty-two patients underwent R-RBS (31%), and 115 underwent LRBS (69%). Thirty-day major and minor complication rates for R-RBS and L-RBS were 1.9% and 5.8% vs 5.2% and 5.2%, respectively (p > .05). There was no difference in readmission rates (3.8% vs 8.7%, p > 0.05) or intraoperative blood loss (35.5 mL vs 37.4 mL, p > .05) between R-RBS and L-RBS. R-RBS resulted in a shorter length of stay when compared with L-RBS (40.2 h vs 62.6 h, p < .05). Conclusions R-RBS has a decreased, albeit non-significant, rate of 30-day major complications with no difference in minor complications, readmission rates, or intraoperative blood loss when compared with L-RBS. R-RBS resulted in a decreased length of stay when compared with L-RBS. Randomized clinical trials are needed to better elucidate our findings. Keywords Bariatric surgery . Revision bariatric surgery . Robotic bariatric surgery . Conversion . Failed gastric band . Failed gastric bypass . Failed sleeve gastrectomy . Reoperative
Introduction Revisional bariatric surgery (RBS) is the fastest growing category of bariatric procedures, more than doubling from 6% of all bariatric procedures in 2013 to 15.4% in 2018 [1]. Bariatric surgical volume has grown yearly since 2011, and now * Maher El Chaar [email protected] 1
St Luke’s University Hospital and Health Network, Bethlehem, PA, USA
2
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
3
Lewis Katz School of Medicine-Temple University, Philadelphia, PA, USA
4
St. Luke’s University Health Network, 240 Cetronia Road Suite 205, North Allentown, PA 18104, USA
exceeds 250,000 cases annually [1, 2]. Each new primary operation adds to the rapidly expanding cohort of potential candidates for revisional bariatric surgery. Long-term rates of revisional surgery have been estimated as high as 56% [3], including 40–50% of patients after pl
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