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Background <p>Gastrojejunostomy (GJ) anastomosis in Roux-en-Y gastric bypass (RYGB) can be performed using various techniques via minimally invasive surgery (MIS). This study evaluates clinical outcomes of robotic hand-sewn versus linear-stapled GJ anastomosis in primary and revisional metabolic and bariatric surgery (MBS).</p> Methods <p>This retrospective study evaluated 64 consecutive patients with severe obesity who underwent robotic Roux-en-Y gastric bypass (RYGB) using the da Vinci Xi system (Intuitive Surgical, Inc., Sunnyvale, CA, USA) at a single center by one surgeon between January 1, 2021, and December 31, 2023. Both primary and revisional procedures were included. Clinical outcomes assessed included 30-day morbidity and mortality, surgical technique (robotic hand-sewn vs. linear-stapled gastrojejunostomy), and the need for re-intervention.</p> Results <p>A total of 64 patients underwent robotic RYGB, with the hand-sewn gastrojejunostomy (GJ) technique performed in 24 cases (38%) and the linear-stapled approach in 40 cases (62%). No anastomotic leaks or intraluminal bleeding were reported in either group. However, three patients in the hand-sewn group developed anastomotic stenosis that required endoscopic balloon dilation.</p> Conclusion <p>Robotic RYGB using either hand-sewn or stapled gastrojejunostomy techniques can be safely executed in an accredited MBS referral center. The fully robotic approach facilitates the use of hand-sewn anastomoses in both primary and revisional settings. The occurrence of anastomotic stenoses in the hand-sewn group is likely attributable to the initial learning curve.</p>

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Robotic Hand-Sewn Versus Linear-Stapled Gastrojejunostomy in Robotic Roux-en-Y Gastric Bypass for Primary and Revisional Metabolic and Bariatric Surgery: German Experience from a Single Center Study

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Miljana Vladimirov,
  • Sjaak Pouwels,
  • Melissa Kemeter,
  • Aman Goyal,
  • Jens Höppner,
  • Hubert Stein,
  • Rodolfo J. Oviedo

摘要

Background

Gastrojejunostomy (GJ) anastomosis in Roux-en-Y gastric bypass (RYGB) can be performed using various techniques via minimally invasive surgery (MIS). This study evaluates clinical outcomes of robotic hand-sewn versus linear-stapled GJ anastomosis in primary and revisional metabolic and bariatric surgery (MBS).

Methods

This retrospective study evaluated 64 consecutive patients with severe obesity who underwent robotic Roux-en-Y gastric bypass (RYGB) using the da Vinci Xi system (Intuitive Surgical, Inc., Sunnyvale, CA, USA) at a single center by one surgeon between January 1, 2021, and December 31, 2023. Both primary and revisional procedures were included. Clinical outcomes assessed included 30-day morbidity and mortality, surgical technique (robotic hand-sewn vs. linear-stapled gastrojejunostomy), and the need for re-intervention.

Results

A total of 64 patients underwent robotic RYGB, with the hand-sewn gastrojejunostomy (GJ) technique performed in 24 cases (38%) and the linear-stapled approach in 40 cases (62%). No anastomotic leaks or intraluminal bleeding were reported in either group. However, three patients in the hand-sewn group developed anastomotic stenosis that required endoscopic balloon dilation.

Conclusion

Robotic RYGB using either hand-sewn or stapled gastrojejunostomy techniques can be safely executed in an accredited MBS referral center. The fully robotic approach facilitates the use of hand-sewn anastomoses in both primary and revisional settings. The occurrence of anastomotic stenoses in the hand-sewn group is likely attributable to the initial learning curve.