PMID- 31932204
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 16
IP  - 3
DP  - 2020 Mar
TI  - Comparative analysis of robotic versus laparoscopic revisional bariatric surgery: 
      perioperative outcomes from the MBSAQIP database.
PG  - 397-405
LID - S1550-7289(19)31120-7 [pii]
LID - 10.1016/j.soard.2019.11.018 [doi]
AB  - BACKGROUND: There are limited data evaluating the role of robotics in revisional 
      bariatric surgery (RBS) compared with laparoscopy. OBJECTIVE: The purpose of this 
      study was to compare perioperative outcomes of laparoscopic and robotic RBS. 
      SETTING: The Metabolic and Bariatric Surgery Accreditation and Quality 
      Improvement Program (MBSAQIP) database. METHODS: The 2015 to 2017 MBSAQIP 
      database was queried for patients undergoing revisional robotic and laparoscopic 
      sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Multivariate 
      logistic regression was used to compare outcomes between robotic and laparoscopic 
      approaches, adjusting for demographic characteristics, co-morbidities, and 
      operative time. RESULTS: A total of 17,012 patients underwent revisional SG with 
      15,935 (93.7%) laparoscopic and 1077 (6.3%) robotic, and 12,442 patients 
      underwent revisional RYGB with 11,212 (90.1%) laparoscopic and 1230 (9.9%) 
      robotic. Overall morbidity was higher in robotic SG compared with laparoscopic SG 
      (6.7% versus 4.5%; adjusted odds ratio 1.51; P < .01) which was not the case 
      after adjustment for operative time. Robotic RYGB was associated with comparable 
      overall morbidity to laparoscopic (9.3% versus 11.6%; adjusted odds ratio .83; P 
      = .07) although respiratory complications, pneumonia, superficial surgical site 
      infections, and postoperative bleeding were lower with robotic RYGB. The robotic 
      approach with both procedures was associated with longer operative time (P < 
      .01). Length of stay was longer in the robotic group for SG (P < .01) but was not 
      different for RYGB (P = .91). CONCLUSIONS: Robotic RBS has an increased 
      complication profile compared with the laparoscopic approach for SG and decreased 
      for RYGB. Further analysis is needed regarding variability in surgeon technique 
      and operative experience to determine what factors contribute to these 
      differences.
CI  - Copyright (c) 2020 American Society for Bariatric Surgery. Published by Elsevier 
      Inc. All rights reserved.
FAU - Nasser, Hassan
AU  - Nasser H
AD  - Department of Surgery, Henry Ford Hospital, Detroit, Michigan.
FAU - Munie, Semeret
AU  - Munie S
AD  - Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 
      Milwaukee, Wisconsin.
FAU - Kindel, Tammy L
AU  - Kindel TL
AD  - Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 
      Milwaukee, Wisconsin.
FAU - Gould, Jon C
AU  - Gould JC
AD  - Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 
      Milwaukee, Wisconsin.
FAU - Higgins, Rana M
AU  - Higgins RM
AD  - Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 
      Milwaukee, Wisconsin. Electronic address: rhiggins@mcw.edu.
LA  - eng
PT  - Journal Article
DEP - 20191203
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
SB  - IM
CIN - Surg Obes Relat Dis. 2020 Apr;16(4):e29-e30. PMID: 32001207
MH  - Accreditation
MH  - *Bariatric Surgery/adverse effects
MH  - Gastrectomy/adverse effects
MH  - *Gastric Bypass/adverse effects
MH  - Humans
MH  - *Laparoscopy
MH  - *Obesity, Morbid/surgery
MH  - Postoperative Complications/epidemiology/etiology
MH  - Quality Improvement
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MBSAQIP
OT  - Revisional bariatric surgery
OT  - Revisional gastric bypass
OT  - Revisional sleeve gastrectomy
OT  - Robot-assisted
OT  - Robotics
EDAT- 2020/01/15 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/01/15 06:00
PHST- 2019/09/03 00:00 [received]
PHST- 2019/11/03 00:00 [revised]
PHST- 2019/11/20 00:00 [accepted]
PHST- 2020/01/15 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/01/15 06:00 [entrez]
AID - S1550-7289(19)31120-7 [pii]
AID - 10.1016/j.soard.2019.11.018 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2020 Mar;16(3):397-405. doi: 10.1016/j.soard.2019.11.018. 
      Epub 2019 Dec 3.