Victoria K Pepper1, Terrence M Rager2,3, Karen A Diefenbach2, Mehul V Raval4, Steven Teich5, Marc P Michalsky2. 1. Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, WB4154, Columbus, OH, 43212, USA. victoria.pepper@nationwidechildrens.org. 2. Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, WB4154, Columbus, OH, 43212, USA. 3. Department of Surgery, OSU Medical Center, Columbus, OH, USA. 4. Division of Pediatric Surgery, Department of Surgery, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA. 5. Department of Pediatric Surgery, Levine Children's Hospital, Charlotte, NC, USA.
Abstract
BACKGROUND: The rising prevalence of childhood obesity and concomitant increase in comorbid disease pose significant challenges for the health care system. While mounting evidence demonstrates the safety and efficacy of bariatric surgery for severely obese adolescents, the potential role of robotic technology has not been well defined. OBJECTIVE: The aim of this study was to establish the safety and efficacy of robotic-assisted laparoscopic sleeve gastrectomy (RSG) in treating severe adolescent obesity. In addition, 30-day outcomes and hospital charges were compared to subjects undergoing RSG versus laparoscopic sleeve gastrectomy (LSG). METHODS: A retrospective analysis of 28 subjects (14 LSG vs. 14 RSG) at a single institution was conducted. Data collection included demographics, body mass index, comorbidities, hospital length of stay (LOS), operative time, 30-day outcomes, and hospital charges. Analysis was performed using chi-square, Fisher's exact, and nonparametric Wilcoxon rank sum tests. RESULTS: There were no differences in subject demographics or comorbidities. While median operative time was longer for RSG vs. LSG (132 vs. 100 min, p = 0.0002), the median LOS for RSG compared to LSG was shorter (69.6 vs. 75.9 h, p = 0.0094). In addition, RSG-related hospital charges were higher ($56,646 vs. $49,498, p = 0.0366). No significant differences in post-operative outcomes or complications were observed. CONCLUSIONS: RSG is equally safe and efficacious when compared to LSG among adolescents. Similar to studies in adults, LOS is shortened while hospital charges are higher. Larger prospective studies are needed to gain insight regarding cost benefit ratios.
BACKGROUND: The rising prevalence of childhood obesity and concomitant increase in comorbid disease pose significant challenges for the health care system. While mounting evidence demonstrates the safety and efficacy of bariatric surgery for severely obese adolescents, the potential role of robotic technology has not been well defined. OBJECTIVE: The aim of this study was to establish the safety and efficacy of robotic-assisted laparoscopic sleeve gastrectomy (RSG) in treating severe adolescent obesity. In addition, 30-day outcomes and hospital charges were compared to subjects undergoing RSG versus laparoscopic sleeve gastrectomy (LSG). METHODS: A retrospective analysis of 28 subjects (14 LSG vs. 14 RSG) at a single institution was conducted. Data collection included demographics, body mass index, comorbidities, hospital length of stay (LOS), operative time, 30-day outcomes, and hospital charges. Analysis was performed using chi-square, Fisher's exact, and nonparametric Wilcoxon rank sum tests. RESULTS: There were no differences in subject demographics or comorbidities. While median operative time was longer for RSG vs. LSG (132 vs. 100 min, p = 0.0002), the median LOS for RSG compared to LSG was shorter (69.6 vs. 75.9 h, p = 0.0094). In addition, RSG-related hospital charges were higher ($56,646 vs. $49,498, p = 0.0366). No significant differences in post-operative outcomes or complications were observed. CONCLUSIONS:RSG is equally safe and efficacious when compared to LSG among adolescents. Similar to studies in adults, LOS is shortened while hospital charges are higher. Larger prospective studies are needed to gain insight regarding cost benefit ratios.
Authors: Sarah E Messiah; Gabriela Lopez-Mitnik; Deborah Winegar; Bintu Sherif; Kristopher L Arheart; Kirk W Reichard; Marc P Michalsky; Steven E Lipshultz; Tracie L Miller; Alan S Livingstone; Nestor de la Cruz-Muñoz Journal: Surg Obes Relat Dis Date: 2012-03-28 Impact factor: 4.734
Authors: Deirdre C Kelleher; Chaya T Merrill; Linda T Cottrell; Evan P Nadler; Randall S Burd Journal: JAMA Pediatr Date: 2013-02 Impact factor: 16.193
Authors: Tomasz Rogula; David Leifer; Jacob A Petrosky; Xiuli Liu; Michal Janik; Valerie Zeer; Piotr Fiedorczuk; Jan Baczek; Philip Schauer Journal: Obes Surg Date: 2019-02 Impact factor: 4.129