A Comparison of Clinical Outcomes Between Two Different Models of Surgical Robots in Roux-en-Y Gastric Bypass.

Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A
Published Date:

Abstract

For the past 20 years, robotic surgical systems have been used for the Roux-en-Y gastric bypass (RYGB). The da Vinci Surgical System (Intuitive Surgical, Inc.) has been one of the most used robotic platforms. This study aims to retrospectively compare the performance of two models of surgical robots. A retrospective comparative study was conducted from a prospective database including all patients who underwent robotic RYGB (RRYGB) from 2011 to 2020. Of a total of 277 patients included, 134 were in the RRYGB using the da Vinci S™ (RRYGB-S™) group and 143 were in the RRYGB using the da Vinci Xi™ (RRYGB-Xi™) group. The mean operative time in the RRYGB-S and RRYGB-Xi groups was 154 ± 28 and 151 ± 32 minutes, respectively ( = .510). The was no statistically significant difference in terms of intraoperative complications between the groups with regard to positive blue test, bleeding, and failure of stapler line. The readmission rate was higher in the RRGB-S group (14.1%) than in the RRYGB-Xi group (3.4%) ( = .004), and it was mainly due to major complications ( = .003) including pouch and gastrojejunostomy anastomotic leaks ( = .001). The nonsurgical complications were statistically significantly higher in the RRYGB-S group (7.4%) than in the RRYGB-Xi group (2.1%) ( < .05), as well as the surgical complications were higher in the RRYGB-S group (7.5%) than in the RRYGB-Xi group (0%) ( < .001). The mean percentage of the total weight loss at 1 and 2 years of follow-up did not show any statistically significant difference ( = .547). The higher complication rate in the S surgical system might be correlated with the initial learning curve and stressed the need for proper robotic surgical training and accurate strategies when introducing emerging technologies into the surgical practice.

Authors

  • María Rita Rodríguez-Luna
    Research Institute against Digestive Cancer, IRCAD, Department of Surgery, Strasbourg, France.
  • Ramon Vilallonga
    Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
  • Renato Roriz-Silva
    Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain.
  • Muthukumaran Rangarajan
    Doctors Hospital Health System, Department of Surgery, Nassau, The Bahamas.
  • Amador García Ruiz de Gordejuela
    Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain.
  • Enric Caubet
    Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
  • Oscar Gonzalez
    Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
  • Mariano Palermo
    Daicim Foundation, Department of Surgery, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.
  • José Manuel Fort
    Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
  • Manel Armengol
    Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.