Ramos Almino Cardoso, Domene Carlos Eduardo, Volpe Paula, Pajecki Denis, D'Almeida Luiz Alfredo Vieira, Ramos Manoela Galvão, Bastos Eduardo Lemos de Souza, Kim Keith Chae
Arq Bras Cir Dig. 2013;26 Suppl 1:2-7. doi: 10.1590/s0102-67202013000600002.
Currently, bariatric surgery is the most effective therapy for morbid obesity, and the laparoscopic approach is considered gold-standard for Roux-en-Y gastric bypass. Totally robotic Roux-en-Y gastric bypass has been proposed as a major evolution in minimally invasive bariatric surgery and its use is becoming more widespread.
To provide an early report of the first Brazilian case-series of totally robotic gastric bypass and perioperative short-term outcomes.
All consecutive patients who underwent totally robotic gastric bypass at two recognized centers of bariatric surgery were included. Patient demographic data, body mass index, operative times, hospital stay, complications and mortality in the 30 postoperative days were recorded. The surgeons received the same training program before the clinical procedures and all the surgeries were performed under the supervision of an experienced robotic surgeon.
The surgeries were performed by five surgeons and included 68 patients (52 women - 76.5%), with a mean age of 40.5 years (range 18 to 59) and mean BMI of 41.3 (35.2 - 59.2). Total mean operative time was 158 minutes (range 90 to 230) and mean overall hospital stay was 48 h. Postoperative surgical complication rate (30 day) was 5.9%, with three minor and one major complication. There was no mortality, leak or stricture.
Even with surgeons in early learning curves, the robotic approach within a well-structured training model was safe and reproducible for the surgical treatment of the morbid obesity.
目前,减肥手术是治疗病态肥胖最有效的方法,腹腔镜手术被认为是Roux-en-Y胃旁路手术的金标准。全机器人Roux-en-Y胃旁路手术已被视为微创减肥手术的一项重大进展,其应用越来越广泛。
提供巴西首例全机器人胃旁路手术病例系列及围手术期短期结果的早期报告。
纳入在两个公认的减肥手术中心接受全机器人胃旁路手术的所有连续患者。记录患者的人口统计学数据、体重指数、手术时间、住院时间、术后30天内的并发症和死亡率。外科医生在临床手术前接受相同的培训项目,所有手术均在经验丰富的机器人外科医生的监督下进行。
手术由五名外科医生完成,包括68例患者(52名女性,占76.5%),平均年龄40.5岁(18至59岁),平均体重指数41.3(35.2至59.2)。总平均手术时间为158分钟(90至230分钟),平均总住院时间为48小时。术后手术并发症发生率(30天)为5.9%,包括3例轻微并发症和1例严重并发症。无死亡、渗漏或狭窄发生。
即使外科医生处于早期学习阶段,在结构完善的培训模式下,机器人手术方法对于病态肥胖的手术治疗也是安全且可重复的。