PMID- 37919532
OWN - NLM
STAT- MEDLINE
DCOM- 20231130
LR  - 20231217
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 33
IP  - 12
DP  - 2023 Dec
TI  - Experience of Robotic Complex Revisional Bariatric Surgery in a High-Volume 
      Center.
PG  - 4034-4041
LID - 10.1007/s11695-023-06916-5 [doi]
AB  - PURPOSE: A revisional bariatric surgery (RBS) is necessary in about 28% of the 
      patients. The role of robotic surgery in RBS is still a subject of debate. We aim 
      to report the outcomes of robotic-assisted RBS at our institution. MATERIALS AND 
      METHODS: We identified patients who underwent robotic-assisted RBSs between 
      January 1, 2016, and May 31, 2022. We analyzed patient demographics and 
      indications for surgery. Measured outcomes included peri- and postoperative 
      morbidity, comorbidity management, and weight loss outcomes. RESULTS: A total of 
      106 patients were included. Primary procedures were adjustable gastric band 44 
      (41.5%), sleeve gastrectomy 42 (39.6%), Roux-en-Y gastric bypass (RYGB) 18 (17%), 
      duodenal switch (DS) 1 (0.9%), and vertical banded gastroplasty 1 (0.9%). RBSs 
      performed included 85 (78.7%) RYGB, 16 (14.8%) redo-gastrojejunostomy, and 5 
      (4.6%) DS. The median time to revision was 8 (range 1-36) years, and the main 
      indication was insufficient weight loss (49%). Median length of hospital stay was 
      2 (range 1-16) days, and 9 (8.5%) patients were readmitted during the first 
      30 days. Only 4 (3.7%) patients had early Clavien-Dindo grade III or higher 
      adverse events. No anastomotic leaks were documented. Median excess weight loss 
      was 35.1%, 42.23%, and 45.82% at the 6-, 12-, and 24-month follow-up. Of 57 
      patients with hypertension, 29 (50.9%) reduced their medication dosage, and 20/27 
      (74.1%) reduced their diabetes mellitus medication dosage. Finally, of the 75 
      patients with symptoms, 64 (85.3%) reported an improvement after the RBS. 
      CONCLUSION: Robotic-assisted RBS is feasible, significantly improves patients' 
      comorbidities and symptoms, and leads to considerable weight loss.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Castillo-Larios, Rocio
AU  - Castillo-Larios R
AUID- ORCID: 0000-0002-2147-9343
AD  - Department of General Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, 
      Jacksonville, FL, 32224, USA.
FAU - Cornejo, Jorge
AU  - Cornejo J
AD  - Department of General Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, 
      Jacksonville, FL, 32224, USA.
FAU - Gunturu, Naga Swati
AU  - Gunturu NS
AD  - Department of General Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, 
      Jacksonville, FL, 32224, USA.
FAU - Cheng, Yilon Lima
AU  - Cheng YL
AD  - Department of General Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, 
      Jacksonville, FL, 32224, USA.
FAU - Elli, Enrique F
AU  - Elli EF
AD  - Department of General Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, 
      Jacksonville, FL, 32224, USA. Elli.enrique@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20231103
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  - *Laparoscopy/methods
MH  - Retrospective Studies
MH  - *Gastric Bypass/adverse effects/methods
MH  - *Gastroplasty/methods
MH  - *Bariatric Surgery/methods
MH  - Weight Loss
MH  - Reoperation/methods
OTO - NOTNLM
OT  - Duodenal Switch
OT  - Redo Gastro-jejunostomy
OT  - Robotic-assisted
OT  - Roux-en-Y Gastric Bypass
OT  - gastric band
OT  - revisional bariatric surgery
EDAT- 2023/11/03 06:43
MHDA- 2023/11/30 06:44
CRDT- 2023/11/03 00:40
PHST- 2023/01/17 00:00 [received]
PHST- 2023/10/18 00:00 [accepted]
PHST- 2023/10/17 00:00 [revised]
PHST- 2023/11/30 06:44 [medline]
PHST- 2023/11/03 06:43 [pubmed]
PHST- 2023/11/03 00:40 [entrez]
AID - 10.1007/s11695-023-06916-5 [pii]
AID - 10.1007/s11695-023-06916-5 [doi]
PST - ppublish
SO  - Obes Surg. 2023 Dec;33(12):4034-4041. doi: 10.1007/s11695-023-06916-5. Epub 2023 
      Nov 3.