Robotic-assisted bariatric surgery: case series analysis and comparison with the laparoscopic approach.

ABSTRACT Objective: to report a series of cases of robotic bariatric surgery in the treatment of obesity in Brazil. Methods: we evaluated patients undergoing robotic bariatric surgery at the Garrido Institute and compared them with a group submitted to conventional laparoscopic surgery. Results: we analyzed 45 patients, with a mean age of 39.44 years, of which 34 were female, with an initial mean BMI of 41.26kg/m2. Among the procedures performed, 91.11% were Roux-en-Y gastric bypass, while 8.89% were sleeve gastrectomy. The mean total surgery time was 158 (±56.54) minutes, with mean docking time of 7.93 (±3.9) minutes, and console time 113.0 (±41.4) minutes. The average pain presented in the post anesthetic recovery was 2.61 (±3.30) points on a scale of 0 to 10; four patients presented with mild signs of nausea, responding well to drug treatment. Only one patient needed ICU admission for a period of two days after surgery due to previous cardiopathy. In two cases, there was an incisional hernia at the trocar site, which were surgically treated without further complications. In the comparison between robotic versus laparoscopic surgery groups, 45 patients were selected for each group. Operative time was significantly longer in the robotic surgery group, with most other variables being equivalent, including postoperative control of comorbidities. Conclusion: robotic bariatric surgery is a safe procedure, with results comparable to laparoscopic surgery.

摘要 目的：报告巴西开展机器人减重手术(robotic bariatric surgery)治疗肥胖症的一系列病例。方法：评估在加里多研究所接受机器人减重手术的患者，并与接受常规腹腔镜手术(conventional laparoscopic surgery)的对照组进行比较。结果：共分析45例患者，平均年龄39.44岁，其中女性34例，初始平均体质量指数(Body Mass Index, BMI)为41.26kg/m²。所实施的手术中，91.11%为Roux-en-Y胃旁路术(Roux-en-Y gastric bypass)，8.89%为袖状胃切除术(sleeve gastrectomy)。平均总手术时长为158(±56.54)分钟，平均对接时间(docking time)为7.93(±3.9)分钟，平均控制台操作时长(console time)为113.0(±41.4)分钟。麻醉复苏期(post anesthetic recovery)的平均疼痛评分为2.61(±3.30)分，评分范围为0~10分；4例患者出现轻度恶心症状，经药物治疗后均得到有效缓解。仅1例患者因既往存在心脏病，于术后需入住重症监护病房(Intensive Care Unit, ICU)治疗2天。2例患者在穿刺套管位点(trocar site)出现切口疝(incisional hernia)，均经手术治疗，未出现后续并发症。在机器人手术组与腹腔镜手术组的对比研究中，每组各纳入45例患者。机器人手术组的手术时长显著更长，其余多数变量无显著差异，包括术后合并症(comorbidities)的控制情况。结论：机器人减重手术是一种安全的术式，其治疗效果可与腹腔镜手术相媲美。