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Three Hundred Four Robotically Assisted Biliopancreatic Diversion with Duodenal Switch Operations with Gradual
Gintaras Antanavicius1, Theodoros Katsichtis2, Waed Alswealmeen1
1Institute for Metabolic and Bariatric Surgery, Abington Jefferson Health, 225 Newton Rd, Warminster, PA, 18974, USA.
Setting:
Community, academic affiliated hospital.
Objectives:
In the recent years, a movement towards robotic-assisted biliopancreatic diversion with duodenal switch (BPD/DS) has reported mixed short-term outcomes. We report our 10-year experience with robotic-assisted BPD/DS in our institution.
Methods:
We conducted a retrospective analysis of 304 consecutive bariatric patients who had robotic or robotic-assisted BPD/DS from December 2008 to February 2018 from a single operating surgeon. Thirty 30-day and 90-day complication and readmission rates were analyzed. No patient was lost to follow-up.
Results:
The median age of the patients was 45 years (interquartile range (IQR) = 16; range = 20-72). Two hundred ten (69.1%) were female. The median pre-op body mass index (BMI) was 49.2 (IQR = 9; range = 34-79). Median operative time was 253.5 min (IQR = 61; range = 124-463). The median hospital length of stay (LOS) was 2 days (IQR = 2; range = 1-13). Thirty-day follow-up revealed 3 major and 20 minor events in 23 patients (7.6%) while there were 4 major and 7 minor events in 6 (2%) patients after 30 days. There were 15 (5%) readmissions within 30 days and 10 (3.2%) additional readmissions occurred past 30 days, but within 90-day period. A need for going back to operating room was observed in 4 (1.3%) patients within 30 days and an additional 5 (1.6%) needed an operation beyond 30 days, but within 90-day period. There was no anastomotic leak and no mortality recorded.
Conclusion:
Robotic-assisted BPD/DS is safe with low early morbidity and mortality.
