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Open Access Research article

Current status of robotic bariatric surgery: a systematic review

Roberto Cirocchi1, Carlo Boselli2, Alberto Santoro3, Salvatore Guarino3, Piero Covarelli2, Claudio Renzi2*, Chiara Listorti2, Stefano Trastulli1, Jacopo Desiderio1, Andrea Coratti4, Giuseppe Noya2, Adriano Redler3 and Amilcare Parisi1

Author Affiliations

1 Department of Digestive and Liver Surgery Unit, St Maria Hospital, Terni, Italy

2 Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy

3 Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy

4 Department of General Surgery, Misericordia Hospital, Grosseto, Italy

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BMC Surgery 2013, 13:53  doi:10.1186/1471-2482-13-53

Published: 7 November 2013

Abstract

Background

Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review.

Methods

A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science.

Results

Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days).

Conclusions

The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy).

Keywords:
Morbid obesity; Bariatric surgery; Robotic; Roux-en-Y gastric bypass; Robot assisted; Gastric bypass; Sleeve gastrectomy; Gastric banding; Duodenal switch; Surgical outcomes; Complications; Anastomotic leak