Robotic Revisional Bariatric Surgery: a High-Volume Center Experience

被引:22
作者
Dreifuss, Nicolas H. [1 ]
Mangano, Alberto [1 ]
Hassan, Chandra [1 ]
Masrur, Mario A. [1 ]
机构
[1] Univ Illinois, Dept Surg, Div Gen Minimally Invas & Robot Surg, 820 S Wood St,Rm 611,Clin Sci North, Chicago, IL 60612 USA
关键词
Robotic surgery; Bariatrics; Revisional surgery; Robotic bariatric surgery; Y GASTRIC BYPASS; TERM-FOLLOW-UP; SLEEVE GASTRECTOMY; MORBID-OBESITY; WEIGHT REGAIN; COMPLICATIONS; CONVERSION; ADVANTAGES; OUTCOMES; LESSONS;
D O I
10.1007/s11695-020-05174-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose The number of bariatric revisional procedures is growing. Scarce evidence is available regarding the role and postoperative outcomes of robotic-assisted revisional bariatric surgery (RRBS). The aim of this study is to evaluate the safety and postoperative outcomes of RRBS. Materials and Methods A retrospective analysis of a prospectively collected database of patients who underwent RRBS between 2012 and 2019 was performed. Primary outcomes of interest were 30-day major morbidity, mortality, length of hospital stay (LOS), urgent reoperation rates, and percentage of total weight loss (%TWL). Results RRBS was performed in 76 patients; among these 60 (78.9%) underwent conversion to Roux-en-Y gastric bypass (C-RYGB). Failed weight loss (76%) and gastroesophageal reflux (9.2%) were the main indications for revision. Primary bariatric procedures included gastric band (LAGB) (50%), sleeve gastrectomy (SG) (40.8%), and RYGB (6.6%). Major morbidity and mortality rates were 3.9% and 1.3%, respectively. Mean LOS was 2.1 days, and 3 patients (3.9%) required urgent reoperation. The %TWL at 3, 6, 12, and 24 months was 10.2%, 16.6%, 18.3%, and 22.4% respectively. Comparative analysis of C-RYGB after failed LAGB and SG showed similar morbidity. Higher readmission rates (SG: 22.2% vs. LAGB: 0%, p = 0.007) and lower %EWL at 3, 6, 12, and 24 months were found in C-RYGB after SG. Conclusion This is one of the largest single-center series of RRBS published in the literature; the data indicate that robotic approach for revisional bariatric surgery is safe and helps achieving further weight loss. RRBS outcomes might be influenced by the primary procedure.
引用
收藏
页码:1656 / 1663
页数:8
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