Wood Michael H, Kroll Joshua J, Garretson Beth
Detroit Medical Center, Harper University Hospital, 3990 John R. Street, Detroit, MI, 48201, USA.
, 1385 East 12 Mile Road, Madison Heights, MI, 48071, USA.
J Robot Surg. 2014 Mar;8(1):29-34. doi: 10.1007/s11701-013-0416-1. Epub 2013 Jun 12.
Background Roux-en-Y gastric bypass is considered to be the gold standard of bariatric procedures. Minimally invasive surgical techniques have been demonstrated to decrease recovery time and provide for favorable cosmetic outcomes. The drawback of traditional laparoscopic techniques for the surgeon comes in the form of 2D monitoring of not always intuitive instrument manipulation. The da Vinci Surgical System provides surgeons with a 3D view and more intuitive instrument manipulation. This study was conducted in order to compare the surgical outcomes and assess the learning curve of traditional laparoscopic Roux-en-Y gastric bypasses (LRYGB) to totally robotic Roux-en-Y gastric bypasses (TRRYGB). A single surgeon's 100 most recent patients who underwent traditional LRYGB and the first 100 patients who underwent TRRYGB were included in this study. Data was collected on patient age, gender, body mass index (BMI), co-morbidities, surgical time, length of admission, and complication rates. No significant differences were found between study groups with respect to age, gender, BMI or any recorded co-morbidities. The mean operative times for patients 1-50 in the TRRYGB and LRYGB groups were 204.34 ± 90.19 min and 151.16 ± 47.16 min, respectively (P = 0.0004). Mean operative times were 159.60 ± 48.26 min and 166.66 ± 44.95 min for patients 51-100 in the TRRYGB and LRYGB groups, respectively (P = 0.45). No significant differences were found between study groups with respect to post-surgical complications or 30-day outcomes. Our data shows that TRRYGB compares favorably to the traditional laparoscopic approach, while maintaining patient safety.
Roux-en-Y胃旁路术被认为是减肥手术的金标准。微创外科技术已被证明可缩短恢复时间并带来良好的美容效果。传统腹腔镜技术对外科医生的缺点在于二维监测，仪器操作并不总是直观的。达芬奇手术系统为外科医生提供了三维视野和更直观的仪器操作。本研究旨在比较传统腹腔镜Roux-en-Y胃旁路术（LRYGB）与全机器人Roux-en-Y胃旁路术（TRRYGB）的手术结果，并评估其学习曲线。本研究纳入了一位外科医生最近进行的100例传统LRYGB患者和首批100例接受TRRYGB的患者。收集了患者的年龄、性别、体重指数（BMI）、合并症、手术时间、住院时间和并发症发生率等数据。研究组在年龄、性别、BMI或任何记录的合并症方面未发现显著差异。TRRYGB组和LRYGB组中第1-50例患者的平均手术时间分别为204.34±90.19分钟和151.16±47.16分钟（P = 0.0004）。TRRYGB组和LRYGB组中第51-100例患者的平均手术时间分别为159.60±48.26分钟和166.66±44.95分钟（P = 0.45）。研究组在术后并发症或30天预后方面未发现显著差异。我们的数据表明，TRRYGB与传统腹腔镜方法相比具有优势，同时保持了患者安全。
