Robotically assisted revision of bariatric surgeries is safe and effective to achieve further weight loss

As more bariatric operations are being performed in the USA every year, the number of revisions has increased. These operations are challenging and have a higher morbidity than the initial operation. We have reviewed our series of robotically assisted revisions.

At the University of Texas Medical School at Houston, we reviewed robotic revision cases from 2004 through 2011 and found 99 bariatric revisions using robotic assistance. Selected endpoints included body mass index (BMI) at follow-up, percent excess weight loss (%EWL), complications, intubation time, operative time, and length of hospital stay.

The average BMI at the time of revision was 44.8 kg/m(2) and fell to 29 kg/m(2) after 3 years. BMI was significantly lower at all time intervals (3, 12, 24, and 36 months) compared to initial BMI (p < 0.001). The %EWL was also significant at 1, 3, 12, 24, and 36 months post-revision (p < 0.001). There was a 24 % (13/55) 90-day readmission rate. The overall complication rate was 17 %, with each individual complication rate between 2 and 4 %. There were no deaths. The average operative time was 204 min, and the average length of hospital stay was 2.3 days.

Revising previous bariatric operations to gastric bypass is difficult and time consuming. Although robotically assisted revision can be done safely and can result in effective further weight loss, the high postoperative complication rate is an issue that warrants further attention.