Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience
Laparoscopy is the surgical standard of care for bariatric procedures; however, during the last two decades, the robotic approach has gained increasing interest. It is currently considered a safe and effective alternative to laparoscopy. This literature review investigates the role of the robotic ap...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.916652/full |
| _version_ | 1818238803792363520 |
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| author | Giovanni Fantola Enrico Moroni Matteo Runfola Emanuele Lai Stefano Pintus Pierpaolo Gallucci Francesco Pennestrì Marco Raffaelli |
| author_facet | Giovanni Fantola Enrico Moroni Matteo Runfola Emanuele Lai Stefano Pintus Pierpaolo Gallucci Francesco Pennestrì Marco Raffaelli |
| author_sort | Giovanni Fantola |
| collection | DOAJ |
| description | Laparoscopy is the surgical standard of care for bariatric procedures; however, during the last two decades, the robotic approach has gained increasing interest. It is currently considered a safe and effective alternative to laparoscopy. This literature review investigates the role of the robotic approach for primary and revisional bariatric procedures, with the particular aim of comparing this technique with the standard-of-care laparoscopic approach. The feasibility of robotic dissection and suturing could have potential advantages: robotics may prevent the risk of leak and bleeding and other surgical complications, determining potential benefits in terms of operative time, length of hospital stay, and learning curve. Considering primary procedures, the literature reveals no advantages in robotic versus the laparoscopic approach for adjustable gastric banding and sleeve gastrectomy. Robotic Roux-en-Y gastric bypass is associated with a longer operative time and a shorter hospital length of stay than laparoscopy. The robotic approach in revisional surgery has been proven to be safe and effective. Despite the longer operative time, the robotic platform could achieve a lower bleeding rate compared with laparoscopy. The surgeon’s selection criteria related to referrals to the robotic approach of difficult-perceived cases could represent a bias. In conclusion, robotic surgery can be considered a safe and effective approach in both primary and revisional bariatric surgery, despite the lack of evidence to support its routine use in primary bariatric surgery. However, in revisional bariatric surgery and in surgical complex procedures, the robotic approach could have potential benefits in terms of surgical complications and learning curves. |
| first_indexed | 2024-12-12T12:47:28Z |
| format | Article |
| id | doaj.art-c477fba71b364d8f8796f445e2eca8a5 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T12:47:28Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-c477fba71b364d8f8796f445e2eca8a52022-12-22T00:24:05ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-05-01910.3389/fsurg.2022.916652916652Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal ExperienceGiovanni Fantola0Enrico Moroni1Matteo Runfola2Emanuele Lai3Stefano Pintus4Pierpaolo Gallucci5Francesco Pennestrì6Marco Raffaelli7Obesity Surgery Unit, Department of Surgery, ARNAS G. Brotzu, Cagliari, ItalyObesity Surgery Unit, Department of Surgery, ARNAS G. Brotzu, Cagliari, ItalyEmergency Surgery Unit, Department of Surgery, ARNAS G. Brotzu, Cagliari, ItalyObesity Surgery Unit, Department of Surgery, ARNAS G. Brotzu, Cagliari, ItalyObesity Surgery Unit, Department of Surgery, ARNAS G. Brotzu, Cagliari, ItalyDivision of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDivision of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDivision of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyLaparoscopy is the surgical standard of care for bariatric procedures; however, during the last two decades, the robotic approach has gained increasing interest. It is currently considered a safe and effective alternative to laparoscopy. This literature review investigates the role of the robotic approach for primary and revisional bariatric procedures, with the particular aim of comparing this technique with the standard-of-care laparoscopic approach. The feasibility of robotic dissection and suturing could have potential advantages: robotics may prevent the risk of leak and bleeding and other surgical complications, determining potential benefits in terms of operative time, length of hospital stay, and learning curve. Considering primary procedures, the literature reveals no advantages in robotic versus the laparoscopic approach for adjustable gastric banding and sleeve gastrectomy. Robotic Roux-en-Y gastric bypass is associated with a longer operative time and a shorter hospital length of stay than laparoscopy. The robotic approach in revisional surgery has been proven to be safe and effective. Despite the longer operative time, the robotic platform could achieve a lower bleeding rate compared with laparoscopy. The surgeon’s selection criteria related to referrals to the robotic approach of difficult-perceived cases could represent a bias. In conclusion, robotic surgery can be considered a safe and effective approach in both primary and revisional bariatric surgery, despite the lack of evidence to support its routine use in primary bariatric surgery. However, in revisional bariatric surgery and in surgical complex procedures, the robotic approach could have potential benefits in terms of surgical complications and learning curves.https://www.frontiersin.org/articles/10.3389/fsurg.2022.916652/fullrobotic surgerydaVincirevisional surgerygastric bypassSADIS |
| spellingShingle | Giovanni Fantola Enrico Moroni Matteo Runfola Emanuele Lai Stefano Pintus Pierpaolo Gallucci Francesco Pennestrì Marco Raffaelli Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience Frontiers in Surgery robotic surgery daVinci revisional surgery gastric bypass SADIS |
| title | Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience |
| title_full | Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience |
| title_fullStr | Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience |
| title_full_unstemmed | Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience |
| title_short | Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience |
| title_sort | controversial role of robot in primary and revisional bariatric surgery procedures review of the literature and personal experience |
| topic | robotic surgery daVinci revisional surgery gastric bypass SADIS |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.916652/full |
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