Bedirli Abdulkadir, Yavuz Aydin, Dikmen Kursat, Buyukkasap Cagri, Ozaydin Safa
Department of General Surgery, Gazi University, Ankara, Turkey.
JSLS. 2022 Jan-Mar;26(1). doi: 10.4293/JSLS.2021.00072.
Robotic bariatric surgery is increasingly adopted by surgeons. We present the surgical results of 527 consecutive patients who underwent robotic Roux-en-Y gastric bypass (RYGB) using the standard technique.
A retrospective analysis of a prospectively maintained database was performed including 527 consecutive patients who underwent robotic RYGB between January 1, 2018 and December 31, 2021.
The mean age of the patients was 41 years, with a male/female sex distribution of 143/384 (27.1%/72.9%). Type 2 diabetes in the pre-operative period was diagnosed in 31% of patients. The median pre-operative body mass index (BMI) was 44.6 kg/m (range, 35-64). The mean operation time was 134 min for robotic RYGB, including the docking process. Early (< 30 days) complications included ileus (0.2%), atelectasis (0.2%), thromboembolic (0.2%) events, and surgical-site infection (0.2%). No leakage or bleeding of the gastrojejunal and jejunojejunal anastomoses were recorded. Oral food intake was begun at 1.8 days on average. The average hospital stay was 2 days. Despite a range of BMI values, operation times and gastrojejunal anastomosis times did not show significant differences. There were no significant differences in mean operation time or mean gastrojejunal anastomosis time over the years.
The robotic approach is effective and safe for patients undergoing RYGB. This technique provides satisfactory results with short-term surgical outcomes. However, the real benefits of robotic RYGB should be further evaluated by well-conducted randomized trials. Even in difficult cases with higher BMI values, optimal operation times and similar operative efficiency can be obtained if a standard operation technique is applied.
机器人减肥手术越来越受到外科医生的青睐。我们展示了527例连续接受机器人辅助 Roux-en-Y 胃旁路术（RYGB）的患者的手术结果，采用的是标准技术。
对一个前瞻性维护的数据库进行回顾性分析，纳入了2018年1月1日至2021年12月31日期间连续接受机器人辅助RYGB的527例患者。
患者的平均年龄为41岁，男女比例为143/384（27.1%/72.9%）。31%的患者在术前被诊断为2型糖尿病。术前体重指数（BMI）中位数为44.6kg/m²（范围35 - 64）。机器人辅助RYGB的平均手术时间为134分钟，包括对接过程。早期（<30天）并发症包括肠梗阻（0.2%）、肺不张（0.2%）、血栓栓塞事件（0.2%）和手术部位感染（0.2%）。未记录胃空肠和空肠空肠吻合口的渗漏或出血情况。平均1.8天开始经口进食。平均住院时间为2天。尽管BMI值范围不同，但手术时间和胃空肠吻合时间并无显著差异。多年来平均手术时间或平均胃空肠吻合时间也无显著差异。
机器人辅助手术对于接受RYGB的患者是有效且安全的。该技术在短期手术结果方面提供了令人满意的效果。然而，机器人辅助RYGB的真正益处应通过精心设计的随机试验进一步评估。即使在BMI值较高的困难病例中，如果应用标准手术技术，也可获得最佳手术时间和相似的手术效率。
