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Australian experience with robot-assisted Roux-en-Y gastric bypass with comparison to a conventional laparoscopic series.
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2021-09-15 , DOI: 10.1007/s00464-021-08723-4
David Sien Chin Soon 1, 2 , Xavier Moar 1, 3 , Dewei Jordan Lee 1, 2 , Patrick Moore 1 , Anthony Clough 1
Affiliation  

BACKGROUND Robotic surgery is a novel approach to abdominal surgery. In Australia, the uptake of robotic assistance for bariatric surgery has been relatively slow compared to many other countries. The aim of this study is to report the first high volume experience of robotic-assisted Roux-en-Y gastric bypass surgery in Australia (RRYGB) and compare outcomes with a similar laparoscopic group (LRYGB). METHODS Retrospective analysis of 100 RRYGB versus 100 LRYGB was carried out over a period of seven years performed by two surgeons. These groups were matched by revisional status. Outcomes recorded included operative times, conversion rate, hospital stay, short-term (30 days) complication rates, and long-term complication rates. Baseline comorbidities of patients were also recorded. RESULTS Baseline characteristics of the two groups were similar except for comorbidity rates (higher in LRYGB group). The mean age was 43 (RRYGB) and 44(LRYGB) years, respectively. The mean pre-op BMI was 44.3 in the RRYGB group and 44.7 in the LRYGB group. Mean operating time in the RRYGB group was 208 min compared to 175 min in the LRYGB group. The number of patients with major complications was 1 in the robotic group versus 5 in the laparoscopic group (P: 0.2166). Minor complications were higher in the robotic group (17 vs. 5, P: 0.0054). Median length of stay of patients with RRYGB was 4 days compared to 5 days for the LRYGB group. CONCLUSION RRYGB has been successfully implemented in Australia with low complication rates compared to conventional laparoscopic RYGB. Operating times are longer compared to LRYGB which is consistent with most published literature. To justify increased costs generally associated with robotic surgery, better quality studies are needed to accurately assess potential cost savings with length of stay and safety benefits to patients and institutions.

中文翻译:

与传统腹腔镜系列相比,澳大利亚在机器人辅助 Roux-en-Y 胃旁路手术方面的经验。

背景技术机器人手术是腹部手术的一种新方法。在澳大利亚,与许多其他国家相比,机器人辅助减肥手术的采用相对缓慢。本研究的目的是报告澳大利亚 (RRYGB) 机器人辅助 Roux-en-Y 胃旁路手术的首次大量经验,并将结果与​​类似的腹腔镜手术组 (LRYGB) 进行比较。方法 由两名外科医生在七年的时间内对 100 RRYGB 与 100 LRYGB 进行了回顾性分析。这些组与修订状态相匹配。记录的结果包括手术时间、转化率、住院时间、短期(30 天)并发症发生率和长期并发症发生率。还记录了患者的基线合并症。结果 除了合并症率(LRYGB 组较高)外,两组的基线特征相似。平均年龄分别为 43 (RRYGB) 和 44(LRYGB) 岁。RRYGB 组术前平均 BMI 为 44.3,LRYGB 组为 44.7。RRYGB 组的平均手术时间为 208 分钟,而 LRYGB 组为 175 分钟。机器人组出现严重并发症的患者人数为 1 人,腹腔镜组为 5 人(P:0.2166)。机器人组的轻微并发症较高(17 对 5,P:0.0054)。RRYGB 患者的中位住院时间为 4 天,而 LRYGB 组为 5 天。结论 与传统腹腔镜 RYGB 相比,RRYGB 已在澳大利亚成功实施,并发症发生率较低。与 LRYGB 相比,运行时间更长,这与大多数已发表的文献一致。为了证明通常与机器人手术相关的成本增加是合理的,需要更高质量的研究来准确评估潜在的成本节约以及对患者和机构的住院时间和安全效益。
更新日期:2021-09-15
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