Robotic-assisted Roux-en-Y Gastric bypass: minimizing morbidity and mortality

Abstract

Background: Despite the rapid acceptance of laparoscopic Roux-en-Y gastric bypass (RYGB) by the community and increase in the number of these procedures being done, there is still significant morbidity and mortality.

Methods: At the University of Texas Medical School at Houston, we have performed 320 RYGB with robotic assistance (RARYGB). Surgical times, length of stay, morbidity, and mortality have been recorded since the beginning of our robotic experience and represent the world's largest single institution series of RARYGB. Outcome data were examined in a postoperative cohort.

Results: The average starting BMI was 49.1 kg/m(2), and it declined by 66% to 32.5 kg/m(2) by the end of 1 year. The average operative time was 192 min, and the average length of stay was 2.7 days. Within the first year, there were a total of 77 (24.1%) complications. The foremost complications noted in the literature to be 3% to 11% were all <1% in our series, and we have no mortalities. Compared to our 356 laparoscopic RYGB, there was a significantly lower gastrointestinal leak rate in the robotic arm. A cohort of 79 postoperative patients was analyzed with respect to weight loss, resolution of co-morbidity, and quality of life. While there was no variation in quality of life over time, weight loss, resolution of co-morbidities, and overall outcome score were significantly improved.

Conclusions: We effectively perform robotic-assisted RYGB that lowers the morbidity and mortality of this procedure compared to today's standard while maintaining thriving outcomes.