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Robotic versus laparoscopic Roux-en-Y gastric bypass: Analysis of mid-term (30 days to 5 years) clinical outcomes and costs

Monika E Hagen, Peter Rohner, Minoa K Jung, Nicolas C Buchs, Leo Buehler, Philippe Morel. University Hospital Geneva

Introduction: While some peri-operative and short term data around laparoscopic and robotic Roux-en-Y gastric bypass (RYGB) are available, mid-term outcomes until 5 years after the procedure including costs do not exist to date. The aim of this analysis was to analyze if there are clinical and/or costs differences in the period of 30 days to 5 years after robotic and laparoscopic RYGB.

Methods and procedures: Patients who underwent robotic or laparoscopic gastric bypass (RYGB) surgery from 2007 to 2015 were analyzed with a follow-up period of 30 days to 5 years after surgery. Clinical data were derived from the institution’s prospective database and completed by retrospective chart review. Cost data of surgical in- and outpatient treatments as well as costs for endoscopic diagnostics and treatments were abstracted from the institution’s medical controlling database.

Results: 597 robotic and 229 laparoscopic RYGB patients were included in this analysis. Demographic parameters as well as rates of biliary complications (p=0.6232), ulcers (p=0.2136) and small bowel obstructions (0.6123) between 30 days and 5 years after surgery were comparable. Fewer internal hernias (1.8% vs 8.3, p=0.0001), fewer gastro-jejunal strictures (0.7% vs 3.9%, p=0.0022) and fewer overall obesity related complications (36.2% vs 54.1%, p=0.0001) were observed for the robotic cohort during the same period. While the overall number of surgical out-patient appointments was similar across cohorts (9.3 vs 10.0, p=0.1069), significantly fewer surgery-related hospitalization days occurred in the robotic cohort (12.7 vs 19.3, p=0.0477). Both surgical in- and outpatient costs were comparable between both cohorts (USD 7 473 vs USD 7 179, p=0.8868 and USD 19 298 vs 20 062, p=0.3298 respectively). Mean costs for endoscopies was lower in the robotic cohort (USD 1 567 vs USD 2 364, p=0.0231).

Conclusions: This data suggest that the robotic technique for RYGB might have a positive impact regarding complications and some cost aspects in the period between 30 days and 5 years after the procedure. Overall surgical mid-term surgical costs appear un-effected by the robotic technique, most likely due to the complexity of these patients. The nature of this data contains shortcomings and further systematic research should be conducted. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 88445

Program Number: S099

Presentation Session: Robotics 2 Session

Presentation Type: Podium

71

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