Our Summary

This research paper compares two types of weight loss surgery: laparoscopic sleeve gastrectomy (LSG) and robot-assisted sleeve gastrectomy (RSG). These surgeries involve reducing the size of the stomach to help people lose weight. The researchers used data from New York hospitals between 2012 and 2018 to see how patients fared after each surgery.

They found that of the 72,157 surgeries they looked at, only a small number (2.6%) were robot-assisted. Patients who had the robot-assisted surgery were more likely to need their procedure changed to an open surgery (where a large cut is made in the body) compared to those who had the laparoscopic surgery (2.3% vs 0.2%). They also stayed in hospital for longer after their operation (2.1 days vs. 1.8 days).

There was no difference in complications after the surgery between the two groups, but people who had the robot-assisted surgery were more likely to visit the emergency room and be readmitted to hospital (5.5% vs. 4.2%). This was also true for patients with a very high body mass index (a measure of obesity).

The robot-assisted surgery was also more expensive, costing on average $47,623 compared to $35,934 for the laparoscopic surgery. This cost difference remained true a year after the surgery ($57,484 vs $43,769).

In conclusion, the researchers found no clear benefits of using a robot to assist with this type of weight loss surgery. The robot-assisted surgery resulted in longer hospital stays and higher costs, without an improvement in patient outcomes.

FAQs

  1. What are the differences between laparoscopic sleeve gastrectomy and robot-assisted sleeve gastrectomy?
  2. Did the research find any benefits of using robot-assisted surgery for weight loss?
  3. Based on the research, which type of weight loss surgery resulted in longer hospital stays and higher costs?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is to carefully consider the type of surgery they choose, as robot-assisted gastrectomy may result in longer hospital stays, higher costs, and a higher likelihood of needing a procedure changed to an open surgery compared to laparoscopic gastrectomy. Patients should weigh the potential benefits and risks of each type of surgery before making a decision.

Suitable For

Patients who are typically recommended gastrectomy are those who have tried other methods of weight loss and have not been successful, have a body mass index (BMI) of 40 or higher, or have a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes or high blood pressure. These patients may be candidates for weight loss surgery to help them achieve significant and sustained weight loss.

Timeline

Before gastrectomy:

  1. Patient meets with healthcare provider to discuss weight loss surgery options.
  2. Patient undergoes pre-operative testing and evaluation to determine eligibility for surgery.
  3. Patient receives education on the procedure, risks, benefits, and post-operative care.
  4. Patient may need to make lifestyle changes and lose weight prior to surgery.
  5. Patient undergoes the gastrectomy surgery.

After gastrectomy:

  1. Patient stays in the hospital for a few days for monitoring and recovery.
  2. Patient follows a strict diet and exercise plan to promote weight loss and prevent complications.
  3. Patient attends follow-up appointments with healthcare provider to monitor progress and address any issues.
  4. Patient may experience changes in appetite, digestion, and weight loss following surgery.
  5. Patient may need to make long-term lifestyle changes to maintain weight loss and improve overall health.

Overall, the timeline of a patient before and after gastrectomy involves thorough evaluation, surgery, recovery, and ongoing support to achieve successful weight loss outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastrectomy surgery?
  2. How long is the recovery period after gastrectomy surgery?
  3. What dietary changes will I need to make after gastrectomy surgery?
  4. Will I need to take any medications or supplements after gastrectomy surgery?
  5. How will gastrectomy surgery affect my ability to absorb nutrients?
  6. What type of follow-up care will I need after gastrectomy surgery?
  7. How many gastrectomy surgeries have you performed, and what is your success rate?
  8. Are there any alternative treatment options to gastrectomy surgery?
  9. Will I need to make any lifestyle changes, such as exercise or counseling, after gastrectomy surgery?
  10. What can I expect in terms of weight loss and long-term outcomes after gastrectomy surgery?

Reference

Authors: Burstein MD, Myneni AA, Towle-Miller LM, Simmonds I, Gray J, Schwaitzberg SD, Noyes K, Hoffman AB. Journal: Surg Endosc. 2022 Sep;36(9):6878-6885. doi: 10.1007/s00464-022-09026-y. Epub 2022 Feb 14. PMID: 35157123