PMID- 37804468
OWN - NLM
STAT- MEDLINE
DCOM- 20231027
LR  - 20231028
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 33
IP  - 11
DP  - 2023 Nov
TI  - Improving Operating Room Efficiency of Robotic-Assisted Metabolic and Bariatric 
      Surgery Through Standardization.
PG  - 3411-3421
LID - 10.1007/s11695-023-06850-6 [doi]
AB  - INTRODUCTION: The use of robotic-assisted (RA) surgery in the field of metabolic 
      and bariatric surgery (MBS) is controversial because of cost concerns and issues 
      related to efficiency. The objective of this study is to evaluate the operating 
      room efficiency in performing RA-MBS prior and after the implementation of a 
      standardized surgical approach. MATERIALS AND METHODS: All MBS cases entered into 
      our database between October 2017 and October 2022 were collected and analyzed 
      before and after the introduction of the standardized approach (SA). The outcome 
      variables consisted of operation time (OT), turnover time (TT), wheels in-wheels 
      out (WW), and console time (CT). Procedures were divided into Roux-en-Y gastric 
      bypass (RYGB), sleeve gastrectomy (SG), and revisional bariatric surgery (RBS). 
      RESULTS: For RYGB (n = 185), we found a significant reduction in OT, TT, and WW 
      after SA (129 min vs 139 min; 37 min vs 73 min; 165 min vs 175 min, respectively, 
      p < 0.05). For SG (n = 253), we found a significant reduction in turnover time 
      (TT) after SA. For RBS (n = 201), we also found a significant reduction in OT, 
      TT, WW, and CT after SA ( 157 min vs 177 min; 36 min vs 72 min; 194 min vs 216 
      min; 119 min vs 134 min, respectively, p < 0.05). CONCLUSION: Using a 
      standardized surgical approach, we were able to demonstrate improved operation 
      room efficiency as demonstrated by a reduction in operation length, turnover 
      time, and the overall time of the procedure for primary RYGB and revisional 
      procedures and turnover time for primary sleeve procedures.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - El Chaar, Maher
AU  - El Chaar M
AUID- ORCID: 0000-0001-5143-9257
AD  - Department of Surgery, St. Luke's University Hospital and Health Network, 1736 
      Hamilton Street, Allentown, PA, 18104, USA. Maher.elchaar@sluhn.org.
FAU - Michaud, Allincia
AU  - Michaud A
AD  - St. Luke's University Hospital and Health Network, 801 Ostrum Street, Bethlehem, 
      PA, 18015, USA.
FAU - Stoltzfus, Jill
AU  - Stoltzfus J
AD  - St. Luke's University Hospital and Health Network, 801 Ostrum Street, Bethlehem, 
      PA, 18015, USA.
FAU - Alvarado, Luis A
AU  - Alvarado LA
AD  - St. Luke's University Hospital and Health Network, 801 Ostrum Street, Bethlehem, 
      PA, 18015, USA.
LA  - eng
PT  - Journal Article
DEP - 20231007
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
SB  - IM
MH  - Humans
MH  - *Obesity, Morbid/surgery
MH  - *Robotic Surgical Procedures/methods
MH  - Operating Rooms
MH  - Retrospective Studies
MH  - *Bariatric Surgery/methods
MH  - *Gastric Bypass/methods
MH  - Gastrectomy/methods
MH  - Reference Standards
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Operating room efficiency
OT  - Robotic-assisted (RA) surgery
OT  - Standardization
EDAT- 2023/10/07 16:41
MHDA- 2023/10/27 06:42
CRDT- 2023/10/07 11:17
PHST- 2023/05/11 00:00 [received]
PHST- 2023/09/24 00:00 [accepted]
PHST- 2023/09/14 00:00 [revised]
PHST- 2023/10/27 06:42 [medline]
PHST- 2023/10/07 16:41 [pubmed]
PHST- 2023/10/07 11:17 [entrez]
AID - 10.1007/s11695-023-06850-6 [pii]
AID - 10.1007/s11695-023-06850-6 [doi]
PST - ppublish
SO  - Obes Surg. 2023 Nov;33(11):3411-3421. doi: 10.1007/s11695-023-06850-6. Epub 2023 
      Oct 7.