Subhashini Ayloo, MD, FACS, Nabajit Choudhury, MD. Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
Aim: Laparoscopic revisional bariatric surgery is fraught with increased morbidity and higher conversion due to the complexity of the procedures. The utility of robotic platform with better ergonomics then laparoscopic approach has not been explored in terms of safety, feasibility and outcomes.
Materials and method: Revisional bariatric surgeries performed from 2009 to 2013 for insufficient weight loss or weight regain or complications from primary procedure were retrospectively reviewed from a prospectively maintained bariatric database.
Results: Of the fourteen cases of revisional bariatric procedures, 5 cases were band to gastric bypass, 6 band to sleeve, 1 stricturoplasy from vertical banded gastroplasty, 2 marginal ulcerations with one case of gastro-gastric fistula. There were 13 women, mean age, preoperative BMI and weight of 45.28 (±11.41) years, 40.12 (±8.71) kg/m2, and 109.43 (±26.09) kg respectively. The mean operative time, hospital stay and estimated blood loss were 220.64(±64.30) minutes, 3.35 (±1.49) days, and 31.07 (±22.71) ml respectively. No intraoperative complications or conversion to open. One case of diagnostic laparoscopy on Post op day 5 for bowel obstruction from a previously existing ventral hernia. Two patients were re-admitted and two patients treated outpatient for pain management.
Conclusion: Robot assisted revisional bariatric procedures can be performed safely without increased morbidity. Larger series might establish a role of robotic platform in these complex procedures.