Schraibman Vladimir, Macedo Antonio L V, Epstein Marina G, Soares Mayte Y, Maccapani Gabriel, Matos Delcio, Rizzo Luiz Vicente, Goldman Suzan M
Obes Surg. 2014 Sep;24(9):1420-4. doi: 10.1007/s11695-014-1239-5.
In recent years, there has been renewed interest in using robotics in bariatric surgery for the treatment of morbid obesity. However, the high cost of a robotic surgical system has hindered its widespread use in developing countries. This study aims to compare the rate of morbidity, weight loss, and relative costs between laparoscopic (LSG) and robotic-assisted sleeve gastrectomy (RSG) performed for the treatment of obesity in a single center in Brazil.
From January 2011 to March 2013, 48 severely obese patients underwent either LSG or RSG at our institution and were prospectively followed up for 12 months. Patients were free to choose either approach and were informed of any extra costs that may be incurred.
Thirty-two patients underwent LSG and 16 patients, RSG. No significant differences were observed between LSG and RSG groups regarding age, sex, BMI, incidence of comorbidities, duration of surgery, and length of hospital stay. Also, there were no significant between-group differences in BMI values evaluated at 6 and 12 months after surgery. Surgical costs were almost twice as high and total hospital costs were approximately 50 % higher in the robotic approach compared to the laparoscopic approach.
Both RSG and LSG had excellent and similar post-operative clinical outcomes. However, the much higher costs of purchasing and maintaining the robotic system are still precluding the use of RSG as a routine approach in the treatment of morbid obesity in Brazil.
近年来，在减重手术中使用机器人技术治疗病态肥胖症重新引起了人们的关注。然而，机器人手术系统的高昂成本阻碍了其在发展中国家的广泛应用。本研究旨在比较巴西一家单一中心进行的腹腔镜袖状胃切除术（LSG）和机器人辅助袖状胃切除术（RSG）治疗肥胖症的发病率、体重减轻情况和相对成本。
2011年1月至2013年3月，48例严重肥胖患者在我们机构接受了LSG或RSG手术，并进行了为期12个月的前瞻性随访。患者可自由选择任何一种手术方式，并被告知可能产生的任何额外费用。
32例患者接受了LSG手术，16例患者接受了RSG手术。在年龄、性别、体重指数、合并症发生率、手术时间和住院时间方面，LSG组和RSG组之间未观察到显著差异。此外，术后6个月和12个月评估的体重指数值在组间也无显著差异。与腹腔镜手术相比，机器人手术的手术成本几乎高出一倍，总住院成本高出约50%。
RSG和LSG均具有良好且相似的术后临床效果。然而，购买和维护机器人系统的成本过高，仍然阻碍了RSG在巴西作为治疗病态肥胖症的常规方法的应用。
