Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: The future of bariatric surgery?

Chan W. Park, Edward C.F. Lam, Teresa M. Walsh, Maxine Karimoto, Adrienne T. Ma, Matthew Koo, Chet Hammill, Kenric Murayama, Cedric S.F. Lorenzo, Racquel Bueno

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Introduction Since receiving Food and Drug Administration approval in 2000, surgery utilizing a robot has been successfully performed in numerous procedures including gastric bypass. However, despite the proven safety profile, reported lower complication rates, and technical benefits of robotic surgery, only a few centers in the USA have consistently applied this technology to bariatric surgery. In addition, there are limited studies with relatively small sample sizes comparing robotic-assisted Roux-en-Y gastric bypass (RRYGB) with laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Through a retrospective analysis of our database, we compared outcomes of RRYGB versus LRYGB in the treatment of morbid obesity. All patients who underwent RRYGB and LRYGB through the Comprehensive Weight Management Program of the Queen's Medical Center (Honolulu, HI) from January 2007 to December 2009 were included. Outcomes data included weight loss, operative times, and hospital length of stay. All complications were reported. Results 105 patients who underwent RRYGB were compared with 195 patients who received LRYGB. Excess weight loss, estimated blood loss, and length of hospital stay were similar in both groups. There were no mortalities in either group. The RRYGB group experienced a 9.5% complication rate versus 9.7% in LRYGB patients. Operative time was the only statistically significant difference, being approximately 17 min in favor of LRYGB. However, there was a steady decrease in RRYGB operative time with increasing experience. Conclusion Our study demonstrates a favorable safety profile with nearly equivalent outcomes and some previously unidentified qualitative benefits of the RRYGB approach to bariatric surgery in a community setting. These results are despite our early experience with the robotic surgery platform and confirm noninferiority of RRYGB versus LRYGB. While the RRYGB operative time was longer than LRYGB, the demonstrated decrease in operative time commensurate with increase in operative experience holds tremendous promise for the future.

Original languageEnglish (US)
Pages (from-to)3312-3321
Number of pages10
JournalSurgical Endoscopy and Other Interventional Techniques
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2011

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Bariatric Surgery
Gastric Bypass
Community Hospital
Robotics
Operative Time
Length of Stay
Weight Loss
Drug Approval
Safety
Morbid Obesity

Keywords

  • Bariatric
  • Gastric bypass
  • Instruments
  • Obesity
  • Robotic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting : The future of bariatric surgery? / Park, Chan W.; Lam, Edward C.F.; Walsh, Teresa M.; Karimoto, Maxine; Ma, Adrienne T.; Koo, Matthew; Hammill, Chet; Murayama, Kenric; Lorenzo, Cedric S.F.; Bueno, Racquel.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 25, No. 10, 01.10.2011, p. 3312-3321.

Research output: Contribution to journalArticle

Park, CW, Lam, ECF, Walsh, TM, Karimoto, M, Ma, AT, Koo, M, Hammill, C, Murayama, K, Lorenzo, CSF & Bueno, R 2011, 'Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: The future of bariatric surgery?', Surgical Endoscopy and Other Interventional Techniques, vol. 25, no. 10, pp. 3312-3321. https://doi.org/10.1007/s00464-011-1714-1
Park, Chan W. ; Lam, Edward C.F. ; Walsh, Teresa M. ; Karimoto, Maxine ; Ma, Adrienne T. ; Koo, Matthew ; Hammill, Chet ; Murayama, Kenric ; Lorenzo, Cedric S.F. ; Bueno, Racquel. / Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting : The future of bariatric surgery?. In: Surgical Endoscopy and Other Interventional Techniques. 2011 ; Vol. 25, No. 10. pp. 3312-3321.
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abstract = "Introduction Since receiving Food and Drug Administration approval in 2000, surgery utilizing a robot has been successfully performed in numerous procedures including gastric bypass. However, despite the proven safety profile, reported lower complication rates, and technical benefits of robotic surgery, only a few centers in the USA have consistently applied this technology to bariatric surgery. In addition, there are limited studies with relatively small sample sizes comparing robotic-assisted Roux-en-Y gastric bypass (RRYGB) with laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Through a retrospective analysis of our database, we compared outcomes of RRYGB versus LRYGB in the treatment of morbid obesity. All patients who underwent RRYGB and LRYGB through the Comprehensive Weight Management Program of the Queen's Medical Center (Honolulu, HI) from January 2007 to December 2009 were included. Outcomes data included weight loss, operative times, and hospital length of stay. All complications were reported. Results 105 patients who underwent RRYGB were compared with 195 patients who received LRYGB. Excess weight loss, estimated blood loss, and length of hospital stay were similar in both groups. There were no mortalities in either group. The RRYGB group experienced a 9.5{\%} complication rate versus 9.7{\%} in LRYGB patients. Operative time was the only statistically significant difference, being approximately 17 min in favor of LRYGB. However, there was a steady decrease in RRYGB operative time with increasing experience. Conclusion Our study demonstrates a favorable safety profile with nearly equivalent outcomes and some previously unidentified qualitative benefits of the RRYGB approach to bariatric surgery in a community setting. These results are despite our early experience with the robotic surgery platform and confirm noninferiority of RRYGB versus LRYGB. While the RRYGB operative time was longer than LRYGB, the demonstrated decrease in operative time commensurate with increase in operative experience holds tremendous promise for the future.",
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AU - Walsh, Teresa M.

AU - Karimoto, Maxine

AU - Ma, Adrienne T.

AU - Koo, Matthew

AU - Hammill, Chet

AU - Murayama, Kenric

AU - Lorenzo, Cedric S.F.

AU - Bueno, Racquel

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