Pavone Giovanna, Pacilli Mario, Gerundo Alberto, Quazzico Andrea, Ambrosi Antonio, Tartaglia Nicola
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Front Surg. 2024 Feb 5;11:1303351. doi: 10.3389/fsurg.2024.1303351. eCollection 2024.
Robotic bariatric surgery serves as an alternative to laparoscopy. The technology provides the surgeon with an accurate three-dimensional view, allowing complex maneuvers while maintaining full control of the operating room.
We report our experience with this innovative surgery compared with laparoscopy during Roux-en-Y gastric bypass to demonstrate its safety and feasibility. The aim of this study is to evaluate potential differences between the robotic and laparoscopic techniques.
Our study retrospectively identified 153 consecutive obese patients who underwent either laparoscopic or robotic gastric bypass (RGB) procedures over a 2-year period at the Department of Medical and Surgical Sciences, University of Foggia. Data on demographics, operative time, conversion rate, length of hospital stay, and mortality were collected and compared between two groups of patients: 82 patients who underwent laparoscopic procedures and 71 who underwent robotic procedures.
We analyzed 153 patients who underwent gastric bypass with a mean age of 42.58 years, of whom 74 were female; 71 were treated with a robotic approach and 82 with a laparoscopic approach. The mean operative time was 224.75 ± 10.4 min for RGB (including docking time) and 101.22 min for laparoscopic gastric bypass (LGB) ( < 0.05), which is statistically significant. The median length of stay was 4.1 days for the RGB group and 3.9 days for the LGB group ( = 0.89). There is only one conversion to laparoscopy in the RGB group. We observed only one case of postoperative complications, specifically one episode of endoluminal bleeding in the laparoscopic group, which was successfully managed with medical treatment. No mortality was observed in either group.
The statistical analysis shows to support the robotic approach that had a lower incidence of complications but a longer operative duration. Based on our experience, the laparoscopic approach remains a technique with more haptic feedback than the robotic approach, making surgeons feel more confident.This study has been registered on ClinicalTrial.gov Protocol Registration and Results System with this ID: NCT05746936 for the Organization UFoggia (https://clinicaltrials.gov/ct2/show/NCT05746936).
机器人减肥手术是腹腔镜手术的一种替代方案。该技术为外科医生提供了精确的三维视野，使复杂操作成为可能，同时能全面掌控手术室。
我们报告了在Roux-en-Y胃旁路手术中，将这种创新手术与腹腔镜手术相比较的经验，以证明其安全性和可行性。本研究的目的是评估机器人技术与腹腔镜技术之间的潜在差异。
我们的研究回顾性分析了153例连续的肥胖患者，这些患者在福贾大学医学与外科学系的两年时间里接受了腹腔镜或机器人胃旁路（RGB）手术。收集了两组患者的人口统计学数据、手术时间、中转率、住院时间和死亡率并进行比较：82例行腹腔镜手术的患者和71例行机器人手术的患者。
我们分析了153例行胃旁路手术的患者，平均年龄42.58岁，其中74例为女性；71例采用机器人手术方式，82例采用腹腔镜手术方式。RGB的平均手术时间（包括对接时间）为224.75±10.4分钟，腹腔镜胃旁路（LGB）为101.22分钟（P<0.05），具有统计学意义。RGB组的中位住院时间为4.1天，LGB组为3.9天（P = 0.89）。RGB组仅1例中转至腹腔镜手术。我们仅观察到1例术后并发症，具体为腹腔镜组1例腔内出血，经药物治疗成功处理。两组均未观察到死亡病例。
统计分析表明支持机器人手术方式，其并发症发生率较低，但手术时间较长。根据我们的经验，腹腔镜手术方式比机器人手术方式具有更多触觉反馈，使外科医生更有信心。本研究已在ClinicalTrial.gov协议注册和结果系统上注册，组织福贾大学的注册号为：NCT05746936（https://clinicaltrials.gov/ct2/show/NCT05746936）。
