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Robot-assisted gastric bypass lowered risk for gastrointestinal leaks
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The use of a robot to assist with laparaoscopic Roux-en-Y gastric bypass surgery appears to significantly lower a patient’s risk for gastrointestinal leaks compared with gastric bypass performed by a surgeon alone.
Minimally invasive surgeons at The University of Texas Medical School at Houston analyzed operative times, length of hospital stay and complications in 605 patients who underwent laparoscopic Roux-en-Y gastric bypass either performed solely by a surgeon (n=356) or with robot assistance (n=249).
Main outcome results were similar between groups. Robot-assisted surgery took 17 minutes longer than the surgeon-only procedure. Hospital stays were an average of three days in both groups, and the overall complication rate was 14% in each group, with fewer than 4% classified as major complications. In the five-year study, there were no deaths in either group.
No patient in the robot-assisted surgery group experienced a gastrointestinal leak; however, six in the other group experienced the complication within 90 days after the surgery. The rate for gastrointestinal leaks and other complications was slightly lower than what has previously been reported in other scientific journals, according to the researchers.
“While robotic surgery may take slightly longer and be more costly to use than traditional laparoscopy, we believe that the improved outcome and decreased leak rates may offset the cost to some extent,” Erik B. Wilson, MD, director of the University of Texas Medical School at Houston Minimally Invasive Surgeons of Texas group, said in a press release. – by Katie Kalvaitis
J Robotic Surg. 2008;2:159-163.
My instinct on the need for robot-assisted techniques for gastric bypass is that it is not obvious to me that it would be an area of great fruitfulness because the manipulations done are not very fine and precise; it is a real broad general surgery. I think robot-assisted techniques are mostly brought to the floor when you have to make extremely small, delicate movements, such as prostectomies, when the whole operation is done in a small, constrained space and where robot-assisted techniques have become the norm. My impression is that is really not so necessary in large abdominal surgeries like gastric bypass.
– David E. Cummings, MD
Associate Professor of Medicine
Division of Metabolism, Endocrinology and Nutrition
Seattle VA Puget Sound Health Care System