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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...

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Autores principales: Fantola, Giovanni, Moroni, Enrico, Runfola, Matteo, Lai, Emanuele, Pintus, Stefano, Gallucci, Pierpaolo, Pennestrì, Francesco, Raffaelli, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194091/
https://www.ncbi.nlm.nih.gov/pubmed/35711697
http://dx.doi.org/10.3389/fsurg.2022.916652
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author Fantola, Giovanni
Moroni, Enrico
Runfola, Matteo
Lai, Emanuele
Pintus, Stefano
Gallucci, Pierpaolo
Pennestrì, Francesco
Raffaelli, Marco
author_facet Fantola, Giovanni
Moroni, Enrico
Runfola, Matteo
Lai, Emanuele
Pintus, Stefano
Gallucci, Pierpaolo
Pennestrì, Francesco
Raffaelli, Marco
author_sort Fantola, Giovanni
collection PubMed
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.
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spelling pubmed-91940912022-06-15 Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience Fantola, Giovanni Moroni, Enrico Runfola, Matteo Lai, Emanuele Pintus, Stefano Gallucci, Pierpaolo Pennestrì, Francesco Raffaelli, Marco Front Surg Surgery 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. Frontiers Media S.A. 2022-05-31 /pmc/articles/PMC9194091/ /pubmed/35711697 http://dx.doi.org/10.3389/fsurg.2022.916652 Text en Copyright © 2022 Fantola, Moroni, Runfola, Lai, Pintus, Gallucci, Pennestrì and Raffaelli. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Fantola, Giovanni
Moroni, Enrico
Runfola, Matteo
Lai, Emanuele
Pintus, Stefano
Gallucci, Pierpaolo
Pennestrì, Francesco
Raffaelli, Marco
Controversial Role of Robot in Primary and Revisional Bariatric Surgery Procedures: Review of the Literature and Personal Experience
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 Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194091/
https://www.ncbi.nlm.nih.gov/pubmed/35711697
http://dx.doi.org/10.3389/fsurg.2022.916652
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