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Trends in Utilization and Perioperative Outcomes in Robotic-assisted Bariatric surgery using the MBSAQIP database: A 4-Year Analysis.
Scarritt, Thomas; Hsu, Chiu-Hsieh; Maegawa, Felipe B; Ayala, Alfonso E; Mobily, Matthew; Ghaderi, Iman.
Afiliación
  • Scarritt T; Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N. Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA.
  • Hsu CH; Epidemiology and Biostatistics Department, University of Arizona College of Public Health, Tucson, AZ, USA.
  • Maegawa FB; Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N. Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA.
  • Ayala AE; Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N. Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA.
  • Mobily M; Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N. Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA.
  • Ghaderi I; Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N. Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA. iman.ghaderi@gmail.com.
Obes Surg ; 31(2): 854-861, 2021 Feb.
Article en En | MEDLINE | ID: mdl-33165753
PURPOSE: Robotic-assisted surgery has become increasingly popular across surgical subspecialties. We aimed to analyze trends in the national utilization and outcomes in bariatric surgery. MATERIALS AND METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) data for 2015-2018 was queried. We included robotic-assisted sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), biliopancreatic diversion with duodenal switch (BPD-DS), and revisional cases. The Kruskal-Wallis test or Wilcoxon rank-sum were used for comparing continuous variables and Cochran-Armitage trend analysis for categorical variables when comparing years, or with Fisher's Exact Test when directly comparing categories. RESULTS: Of 760,076 bariatric cases performed between 2015 and 2018, 7.4% with robotic and 90.4% with laparoscopic approach. SG constituted 61.3% of robotic volume. Utilization of robotic surgery increased 1.96-fold; SG represented the most substantial increase of 2.16-fold, followed by a 1.53-fold in RYGB. The 30-day readmission and re-intervention rates decreased from 5.63% to 4.78% (p<0.01), and 2.31% to 1.46% (p<0.01), respectively. The overall leak rate improved from 0.64% to 0.39% (p=0.01). Mortality and re-operations remained statistically unchanged. When compared to laparoscopic approach, the operative time were significantly longer in the robotic group. Regarding postoperative outcomes, when adjusted for patient characteristics, there were no differences between two approaches except a higher leak rate in robotic group in 2015. CONCLUSION: A steady increase in robotic bariatric surgery is apparent. While the operative time remains significantly longer in the robotic group, trends indicate improvement in key quality metrics and patient outcomes as utilization increases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Derivación Gástrica / Laparoscopía / Cirugía Bariátrica / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Derivación Gástrica / Laparoscopía / Cirugía Bariátrica / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos