Ayloo Subhashini, Roh Younghoon, Choudhury Nabajit
Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood St., Mail Code 958, Suite 435E, Chicago, IL, 60612, USA.
Department of Surgery, Dong-A University Hospital, 3 Ga-1, Dongdaesin-dong, Seo-gu, Busan, 602-715, Korea.
J Robot Surg. 2016 Mar;10(1):41-7. doi: 10.1007/s11701-016-0559-y. Epub 2016 Jan 25.
The laparoscopic approach to Roux-en-Y gastric bypass (RYGB) is a highly regarded and frequently used bariatric procedure. We review our experience with robotic approaches to RYGB. We hypothesized that the robotic approach is safe and may produce similar outcomes to previously reported laparoscopic surgery. We conducted our study at the University Hospital, USA. Data regarding RYGB procedures performed in 2006-2013 were retrospectively reviewed from a prospectively maintained, dedicated database. Procedures were categorized into three groups: laparoscopic, hybrid robotic (HR), and total robotic (TR). Patient characteristics, operative variables, and postoperative short- and long-term outcomes were compared between groups and to recently published larger laparoscopic series. Our study included 192 RYGB consecutive patients who underwent laparoscopic, HR, or TR surgery. Mean patient age, preoperative body mass index, and preoperative weight were 40.4 ± 9.3 years (range 22-64), 46. 2 ± 5.9 kg/m(2) (range 35-64), and 130. 3 ± 22.1 kg (range 76.7-193.4) respectively. Ninety-two patients (47.9 %) had undergone previous abdominal surgery. Mean operative time, estimated blood loss, and length of stay were 223.4 ± 39.2 min (range 130-338), 21.9 ± 18.8 mL (range 5-10), and 2.6 ± 1.1 days (range 2-15), respectively. There were 248 concomitant procedures such as upper endoscopy, cholecystectomy, etc., 7 revisional surgeries, and 2 conversions to open surgery. Intraoperative complications included one liver laceration and one bowel injury. There were two cases each of bowel obstruction, transfusions, and deep vein thrombosis/pulmonary embolus, but no deaths or anastomotic leaks. Early experience with TR approach for RYGB is safe, with similar outcomes to the laparoscopic approach.
腹腔镜下 Roux-en-Y 胃旁路术（RYGB）是一种备受推崇且常用的减肥手术。我们回顾了我们采用机器人辅助方法进行 RYGB 的经验。我们假设机器人辅助方法是安全的，并且可能产生与先前报道的腹腔镜手术相似的结果。我们在美国大学医院开展了这项研究。从一个前瞻性维护的专用数据库中回顾性分析了 2006 年至 2013 年期间进行的 RYGB 手术的数据。手术分为三组：腹腔镜手术、混合机器人手术（HR）和全机器人手术（TR）。比较了各组之间以及与最近发表的更大规模腹腔镜系列研究的患者特征、手术变量以及术后短期和长期结果。我们的研究纳入了 192 例连续接受腹腔镜手术、HR 手术或 TR 手术的 RYGB 患者。患者的平均年龄、术前体重指数和术前体重分别为 40.4 ± 9.3 岁（范围 22 - 64 岁）、46.2 ± 5.9 kg/m²（范围 35 - 64）和 130.3 ± 22.1 kg（范围 76.7 - 193.4）。92 例患者（47.9%）曾接受过腹部手术。平均手术时间、估计失血量和住院时间分别为 223.4 ± 39.2 分钟（范围 130 - 338）、21.9 ± 18.8 mL（范围 5 - 10）和 2.6 ± 1.1 天（范围 2 - 15）。有 248 例伴随手术，如内镜检查、胆囊切除术等，7 例翻修手术，2 例转为开放手术。术中并发症包括 1 例肝裂伤和 1 例肠损伤。肠梗阻、输血以及深静脉血栓形成/肺栓塞各有 2 例，但无死亡或吻合口漏发生。RYGB 的 TR 方法早期经验是安全的，与腹腔镜方法的结果相似。
