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Revista de sanidad militar

Print version ISSN 0301-696X

Abstract

PEREYRA-TALAMANTES, Armando et al. Safety and efficacy of robot-assisted Roux-en-Y gastric bypass versus conventional laparoscopic approach. Rev. sanid. mil. [online]. 2023, vol.77, n.3, e03.  Epub Mar 23, 2024. ISSN 0301-696X.  https://doi.org/10.56443/rsm.v77i3.618.

Introduction:

Bariatric surgery is currently considered the most effective treatment option for morbid obesity. The laparoscopic Roux-en-Y gastric bypass remains the gold standard in bariatric surgery. The advent of surgical robotics has led to a reduction in some of the most difficult challenges in advanced laparoscopy.

Objective:

To determine the safety and efficacy of robot-assisted Roux-en-Y gastric bypass compared to the laparoscopic approach.

Material and methods:

A retrospective study was carried out that included 50 patients with different degrees of obesity divided into two groups of 25 patients each. A database was created with the variables according to the type of surgical approach (robotic and laparoscopic), recording the days of hospital stay, bleeding, surgical time, complications, hospital readmissions, complications, and BMI decrease.

Results:

In the laparoscopic group, intraoperative bleeding of 115.8+64 milliliters was observed, in the robotic group it was only 59.6+45.8 milliliters (p<0.001). A laparoscopic surgical time of 151.8+34.6 minutes, while the robotic group was of 216.4+50 minutes, the patients remained hospitalized 4.2+2.4 days in the laparoscopic group, the patients in the robotic group 3.4+1 days, with no significant difference (p=0.077). In both groups there were no hospital readmissions. In the laparoscopic group, the decrease in BMI was 8.9+2.5, while for the robotic group it was 13.7+2.3 with statistical significance (p<0.001).

Discussion:

Robot-assisted Roux-en-Y gastric bypass is more safe and effective compared to the laparoscopic approach. The robotic approach significantly reduces intraoperative bleeding, decreases the days of hospital stay (with no significant difference), and significantly reduces the decrease in BMI, without increasing 30-day hospital readmissions or complications.

Keywords : Roux-en-Y gastric bypass; bariatric surgery; surgical robotics; laparoscopy; obesity.

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