Robot-Assisted Roux-en-Y Gastric Bypass for Super Obese Patients: A Comparative Study

Buchs, Nicolas ; Pugin, François ; Chassot, Gilles ; Volonte, Francesco ; Koutny-Fong, Pascale ; Hagen, Monika ; Morel, Philippe

In: Obesity Surgery, 2013, vol. 23, no. 3, p. 353-357

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    Superobese patients (SO) (body mass index (BMI) ≥ 50kg/m2) represent a real surgical challenge and the best management remains debatable. While the safety of a laparoscopic approach has been questioned for this population, robotics has been introduced in the armamentarium of the bariatric surgeon, yet its role remains poorly assessed, especially for a very high BMI. The study aim is thus to report our experience with robot-assisted Roux-en-Y gastric bypass (RYGB) for SO. From July 2006 to May 2012, 288 consecutive robot-assisted RYGB procedures have been performed at a single institution. All data were collected prospectively in a dedicated database. Among those patients, 41 were SO (14.2%). All the peri- and postoperative parameters were compared to the morbidly obese (MO) group (BMI < 50). Data have been reviewed retrospectively. The SO group presented a higher ASA score and more male patients. The operative time was similar between both groups, yet there were more conversions in the SO group (two versus one for MO; p = 0.05). The morbidity and mortality rates were similar between both groups. The length of stay was longer for the SO population (7 vs. 6days; p = 0.03). The percent BMI loss was similar at 1year (34 vs. 34%; p = 1), but the percent excess BMI loss was higher for the MO group (83 vs. 65% for the SO group; p = 0.0007). Robot-assisted RYGB can be performed safely for SO, with complication rates and functional results at 1year comparable to MO, yet this approach for SO has been associated with a slightly increased conversion rate and length of stay