The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Pr
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ORIGINAL CONTRIBUTIONS
The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures Robotic Vs. Laparoscopic RYGB Jan Henrik Beckmann 1 & Alexander Bernsmeier 1 & Jan-Niclas Kersebaum 1 & Anne-Sophie Mehdorn 1 & Witigo von Schönfels 1 & Terbish Taivankhuu 1 & Matthias Laudes 2 & Clemens Schafmayer 3 & Jan-Hendrik Egberts 1 & Thomas Becker 1
# The Author(s) 2020
Abstract Background Proximal Roux-en-Y gastric bypass is commonly used to manage obesity, performed using laparoscopic or robotassisted minimally invasive surgery. As the prevalence of robotic bariatric surgery increases, further data is required to justify its use. Methods This was a large, retrospective analysis of prospectively recorded data for Roux-en-Y gastric bypass (RYGB) procedures performed using laparoscopic (LRYGB) or robotic (RRYGB; da Vinci Xi system, Intuitive Surgical Sàrl) surgery between January 2016 and March 2019. The surgical techniques did not differ apart from different trocar placements. Data collected included patient characteristics before and after RYGB, operative outcomes and complications. Results In total, 114 RRYGB and 108 LRYGB primary surgeries were performed. There were no significant differences between the groups, apart from a significantly shorter duration of surgery (116.9 vs. 128.9 min, respectively), lower C-reactive protein values at days 1 (31.1 vs. 44.1 mg/l) and 2 (50.3 vs. 77.8 mg/l) after the intervention, and overall complication rate (4.4 vs. 12.0%, Clavien-Dindo classification II-V) with RRYGB compared with LRYGB. There was a lower hemoglobin value in the postoperative course after RRYGB (12.1 vs. 12.6 g/dl, day 2). Conclusions In our experience, robotic RYGB has proven to be safe and efficient, with a shorter duration of surgery and lower rate of complications than laparoscopic RYGB. RRYGB is easier to learn and seems safer in less experienced centers. Increasing experience with the robotic system can reduce the duration of surgery over time. Further studies with higher evidence level are necessary to confirm our results. Keywords Laparoscopy . Obesity . Robotic surgery . Roux-en-Y gastric bypass
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04508-1) contains supplementary material, which is available to authorized users. * Jan Henrik Beckmann [email protected] 1
Department of General, Visceral, Thoracic, Transplantation, and Pediatric Surgery, Kurt-Semm Center for Laparoscopic and Robotic Assisted Surgery, University Hospital Schleswig Holstein, Campus Kiel, Arnold Heller Strasse 3, 24105 Kiel, Germany
2
I. Department of Medicine, University Hospital Schleswig Holstein, Campus Kiel, Arnold Heller Strasse 3, 24105 Kiel, Germany
3
Department of General, Visceral, Vascular, and Transplantation Surgery, University Hospital Rostock, Schillingallee 35, 18057 Rostock, Germany
Introduction Proximal Roux-en-Y gastric bypass is the most frequently performed bariatric procedure in
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