<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0301-696X</journal-id>
<journal-title><![CDATA[Revista de sanidad militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. sanid. mil.]]></abbrev-journal-title>
<issn>0301-696X</issn>
<publisher>
<publisher-name><![CDATA[Secretaría de la Defensa Nacional, Dirección General de Sanidad]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0301-696X2023000300003</article-id>
<article-id pub-id-type="doi">10.56443/rsm.v77i3.618</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Seguridad y eficacia del bypass gástrico en Y de Roux asistido por robot versus abordaje laparoscópico convencional]]></article-title>
<article-title xml:lang="en"><![CDATA[Safety and efficacy of robot-assisted Roux-en-Y gastric bypass versus conventional laparoscopic approach]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereyra-Talamantes]]></surname>
<given-names><![CDATA[Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallaga-Rojas]]></surname>
<given-names><![CDATA[Marco Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vergara-Tamayo]]></surname>
<given-names><![CDATA[Emmanuel Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Morales]]></surname>
<given-names><![CDATA[Oscar Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Silverio]]></surname>
<given-names><![CDATA[Jesús Emmanuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Secretaría de la Defensa Nacional Hospital Central Militar ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Secretaría de la Defensa Nacional Escuela Militar de Graduados de Sanidad ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<volume>77</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0301-696X2023000300003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0301-696X2023000300003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0301-696X2023000300003&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  La cirugía bariátrica se considera actualmente la opción de tratamiento más eficaz para la obesidad mórbida. El bypass gástrico laparoscópico en Y de Roux sigue siendo el estándar de oro en cirugía bariátrica. El advenimiento de la robótica quirúrgica ha llevado a una reducción de algunos de los desafíos más difíciles en la laparoscopia avanzada.  Objetivo:  Determinar la seguridad y eficacia del bypass gástrico en Y de Roux asistido por robot en comparación con el abordaje laparoscópico.  Material y métodos:  Se realizó un estudio retrospectivo que incluyo 50 pacientes con distintos grados de obesidad divididos en dos grupos de 25 cada uno. Se realizó una base de datos con las variables de acuerdo al tipo de abordaje quirúrgico (robótico y laparoscópico), registrando los días de estancia hospitalaria, sangrado, tiempo quirúrgico, complicaciones, reingresos hospitalarios, complicaciones y disminución del IMC.  Resultados:  En el grupo laparoscópico se observó un sangrado transoperatorio de 115.8+64 mililitros, en el grupo robótico solo fue de 59.6+45.8 mililitros (p&lt;0.001). Un tiempo quirúrgico laparoscópico de 151.8+34.6 minutos, mientras que el grupo robótico fue de 216.4+50 minutos, los pacientes permanecieron hospitalizados 4.2+2.4 días en el grupo laparoscópico, los pacientes del grupo robótico 3.4+1 días, sin diferencia significativa (p=0.077). En ambos grupos no hubo reingresos hospitalarios. En el grupo laparoscópico la disminución de IMC fue de 8.9+2.5, mientras que para el grupo robótico fue de 13.7+2.3 con significancia estadística (p&lt;0.001).  Discusión:  El bypass gástrico en Y de Roux asistido por robot es más seguro y eficaz en comparación con el abordaje laparoscópico. El abordaje robótico disminuye de forma significativa el sangrado transoperatorio, disminuye los días de estancia hospitalaria (sin diferencia significativa) y reduce de forma significativa la disminución del IMC, sin aumentar los reingresos hospitalarios a 30 días ni las complicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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&lt;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&lt;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.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Roux-en-Y gastric bypass]]></kwd>
<kwd lng="en"><![CDATA[bariatric surgery]]></kwd>
<kwd lng="en"><![CDATA[surgical robotics]]></kwd>
<kwd lng="en"><![CDATA[laparoscopy]]></kwd>
<kwd lng="en"><![CDATA[obesity]]></kwd>
<kwd lng="es"><![CDATA[Bypass gástrico en Y de Roux]]></kwd>
<kwd lng="es"><![CDATA[cirugía bariátrica]]></kwd>
<kwd lng="es"><![CDATA[robótica quirúrgica]]></kwd>
<kwd lng="es"><![CDATA[laparoscopia]]></kwd>
<kwd lng="es"><![CDATA[obesidad]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>Organización Mundial de la Salud</collab>
<source><![CDATA[Obesidad y sobrepeso]]></source>
<year>2015</year>
<publisher-name><![CDATA[Organización Mundial de la Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<collab>Secretaria de Salud</collab>
<article-title xml:lang=""><![CDATA[NORMA Oficial Mexicana NOM-008-SSA3-2010, Para el tratamiento integral del sobrepeso y la obesidad. NOM-008-SSA3-2010 Jul 7]]></article-title>
<source><![CDATA[Diario Oficial de la Federación]]></source>
<year>2010</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Dayyeh]]></surname>
<given-names><![CDATA[BKA]]></given-names>
</name>
<name>
<surname><![CDATA[Port]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Camilleri]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recent advances in clinical practice challenges and opportunities in the management of obesity]]></article-title>
<source><![CDATA[Gut]]></source>
<year>2014</year>
<volume>63</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>687-95</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<collab>McKinsey Global Institute</collab>
<article-title xml:lang=""><![CDATA[Overcoming obesity: An initial economic analysis]]></article-title>
<source><![CDATA[McKinsey Global Institute]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<collab>Secretaría de Salud</collab>
<source><![CDATA[Estrategia Nacional para la Prevención y el Control del Sobrepeso, la Obesidad y la Diabetes]]></source>
<year>2013</year>
<page-range>105</page-range><publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Secretaría de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Swidnicka-Siergiejko]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wróblewski]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Dabrowski]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoscopic Treatment of Obesity]]></article-title>
<source><![CDATA[Canadian Journal of Gastroenterology and Hepatology]]></source>
<year>2011</year>
<volume>25</volume>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<collab>Organization for the Economic Cooperation and Development</collab>
<source><![CDATA[Obesity Update 2012]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Estados Unidos ]]></publisher-loc>
<publisher-name><![CDATA[OECD]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<collab>Instituto Nacional de Salud</collab>
<source><![CDATA[Encuesta Nacional de Salud y Nutrición, Resultados Nacionales 2012]]></source>
<year>2012</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Secretaria de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lyn-Sue]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Winder]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kotch]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colello]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Docimo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic gastric bypass to robotic gastric bypass: time and cost commitment involved in training and transitioning an academic surgical practice]]></article-title>
<source><![CDATA[J Robotic Surg]]></source>
<year>2016</year>
<volume>10</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>111-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buchs]]></surname>
<given-names><![CDATA[NC]]></given-names>
</name>
<name>
<surname><![CDATA[Morel]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Azagury]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Jung]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chassot]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Huber]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic Versus Robotic Roux-En-Y Gastric Bypass: Lessons and Long-Term Follow-Up Learned From a Large Prospective Monocentric Study]]></article-title>
<source><![CDATA[OBES SURG]]></source>
<year>2014</year>
<volume>24</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2031-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Lam]]></surname>
<given-names><![CDATA[ECF]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Karimoto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ma]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
<name>
<surname><![CDATA[Koo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: the future of bariatric surgery?]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2011</year>
<volume>25</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>3312-21</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stefanidis]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bailey]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Kuwada]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Simms]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gersin]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Robotic gastric bypass may lead to fewer complications compared with laparoscopy]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2018</year>
<volume>32</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>610-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Strong]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
<name>
<surname><![CDATA[Tu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Brethauer]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Schauer]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Aminian]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Robotic platform for gastric bypass is associated with more resource utilization: an analysis of MBSAQIP dataset]]></article-title>
<source><![CDATA[Surgery for Obesity and Related Diseases]]></source>
<year>2018</year>
<volume>14</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>304-10</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smeenk]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Van &#8216;t Hof]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Elsten]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Feskens]]></surname>
<given-names><![CDATA[PGBM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Results of 100 Robotic Versus 100 Laparoscopic Gastric Bypass Procedures: a Single High Volume Centre Experience]]></article-title>
<source><![CDATA[OBES SURG]]></source>
<year>2016</year>
<volume>26</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1266-73</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Doble]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Wordsworth]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rogers]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Welbourn]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Byrne]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Blazeby]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[What Are the Real Procedural Costs of Bariatric Surgery? A Systematic Literature Review of Published Cost Analyses]]></article-title>
<source><![CDATA[OBES SURG]]></source>
<year>2017</year>
<volume>27</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>2179-92</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
