Revisional bariatric surgery using robotic-assisted surgery in a national medical center in Mexico

• Published in: Journal of robotic surgery Vol. 18; no. 1; p. 247
• Main Authors: Gaytán Fuentes, Omar Felipe, Barajas Galicia, Edith, Chávez García, Geovany, Galván Remigio, Isabel, Oviedo, Rodolfo J., Gaytán Fuentes, Israel Abraham, Ayala Ventura, Gustavo Andrés, Barba Mendoza, Jairo Arturo
• Format: Journal Article
• Language: English
• Published: London Springer London 08.06.2024; Springer Nature B.V
• Subjects: Adult; Bariatric Surgery - methods; Body mass index; Body weight; Comparative analysis; Correspondence; Demographic variables; Demographics; Dissection; Female; Gastric Bypass - methods; Gastroesophageal reflux; Gastrointestinal surgery; Health care facilities; Hospitals; Humans; Laparoscopy; Laparoscopy - methods; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Metabolism; Mexico; Middle Aged; Minimally Invasive Surgery; Mortality; Obesity; Obesity, Morbid - surgery; Operative Time; Overweight; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Reoperation - statistics & numerical data; Retrospective Studies; Robotic surgery; Robotic Surgical Procedures - methods; Robotic Surgical Procedures - statistics & numerical data; Surgeons; Surgery; Treatment Outcome; Urology; Weight control; Weight Loss; Mexico; Robotic surgery; Revisional bariatric surgery; LAGB; Weight regain; RRYGB; Weight loss
• ISSN: 1863-2483; 1863-2491; 1863-2491
• DOI: 10.1007/s11701-024-01980-0

Long-term postoperative complications of metabolic and bariatric surgery (MBS) are more frequent than those of primary surgery. Robotic-assisted procedures offer several advantages over traditional laparoscopy, but there are limited data. A retrospective study of 29 patients who underwent a revisional robotic-assisted Roux-en-Y gastric bypass (RRYGB) in a Tertiary Level Hospital. Variables included were demographics, causes for revision, operative details, complications, and weight loss outcomes up to 54 month post-RRYGB. Causes for conversion were weight loss failure (WLF), weight regain (WR), Gastroesophageal Reflux Disease (GERD), or Joint Pain (JP). We assessed 29 patients. Causes for conversion included WLF (34%), WR (15%), WR with GERD (20%), GERD (24%), and JP (3%). Initial BMI was 53.43 kg/m 2  ± 8.75. Mean length of hospital stay (LOS) was 2 days. Total operative time was 126 min. ± 43.45. Excess weight loss at 1 year post-surgery was 82.66% ( p  < 0.0001), with mean BMI of 30.93 kg/m 2 ( p  < 0.001). At 3 years, mean %EWL was 71.26% and a mean BMI 33.81 kg/m2 ( p  < 0.0001). At 4.5 years, mean %EWL was 59.29% and mean BMI 37.27 kg/m 2 ( p  < 0.0001). One complication (8%) was found (jejunojejunal stenosis). There was no mortality. The initial experience with RRYGB shows acceptable outcomes, including low morbidity, no mortality, excellent weight loss after the revisional surgery, and promising reduction in operative times, with important implications on reduction of the total cost of the procedure.