Laparoscopic versus full robotic Roux-en-Y gastric bypass: retrospective, single-center study of the feasibility and short-term results.

Robotic bariatric surgery is an alternative to laparoscopy. It gives the surgeon an accurate three-dimensional view, allowing complex maneuvers while maintaining full control of the theater. We report our experience with this innovative surgery compared with laparoscopy during Roux-en-Y gastric bypass, to demonstrate its safety and feasibility. Our single-center study retrospectively identified obese patients who underwent either laparoscopic or robot-assisted gastric bypass procedures over a 2-year period. Demographics, intraoperative outcomes, mortality and morbidity data were collected. Of the 343 gastric bypass procedures identified, 147 were laparoscopic and 196 robotic-assisted. There were significant differences in age and BMI, being younger and more obese in the robotic group (p = 0.001). The mean operative time was longer in the robotic group; the mean additional time was required for docking, otherwise, the surgical time between groups was comparable. Operative time decreased in line with increasing skills. The conversion rate to laparotomy was 1% (robotic group). Morbidity was generally lower in the robotic group compared with laparoscopy, (hemorrhages 2.5% vs. 6.8%, respectively; anastomotic fistulas 0.5% vs. 2.7%). Statistically, results seem to favor robotic assistance. No mortality was observed in either group. The mean hospital stay was significantly shorter in the robotic group (p = 0.007). Robotic gastric bypass is feasible and, within the reach of every laparoscopic surgeon. Its results are comparable to laparoscopy and surgery is facilitated in higher BMI patients. Randomized, prospective studies are necessary to support our results.

Building a collaboration to improve surgical research through EORTC/ESSO 1409-CLIMB study: A prospective liver metastasis database with an integrated quality assurance program.

The challenges of conducting surgical oncology trials have resulted to low quantity and poor quality research [1,2]. Considering the definitive role of surgery to offer cure, immediate response to improve surgical research is needed [3]. The European Organization for Research and Treatment of Cancer (EORTC) and the European Society of Surgical Oncology (ESSO) share the vision to achieve excellent surgical research and care for cancer patients. Building on their complimentary expertise, they embarked on a pilot project to map out challenges and initiate a sustainable collaboration to advance cancer surgery research in Europe. This pilot project is EORTC-ESSO 1409 GITCG/ ESSO-01: A Prospective Colorectal Liver Metastasis Database with an Integrated Quality Assurance Program (CLIMB). This article will describe the challenges, milestones and vision of both organizations in setting up this collaboration.