Page 6 - Journal of Laparoscopic Surgery

RF Ijah et al
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complications were the measures of outcome studied in Frezza EE et al report of duration of 1 day and 28 days
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comparing RSG to SLSG. The table below is a summarized reported by burgos AM et al among 214 patients who had
highlight of the comparison between SLSG and RSG in terms gastric leak. This observed difference was obviously due to
of the measures of outcome. absence of major complications in this study.
The mean duration of surgery of 142.7 minutes for SLSG The mean percentage excess weight loss for SLSG at
and 150.4 minutes RSG (ratio 1:1.05) were in agreement 1 year was 83.8 and 82.0% for RSG (ratio 1.02:1). This
with previous studies 11,15-17 in which the duration of RSG difference is less than significant. However, this value is
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was longer than SLSG. There was a wide variation in time similar to previous studies which reported 47 to 83% and
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from 121 to 150 minutes for SLSG and 132 to 188 minutes 33 to 90% in 1 year, but differs from that of Damantis T
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for RSG. The RSG mean docking time of 17.9 minutes in this et al which recorded 60.8 ± 4.3. Varied patients adherence
study obviously contributed to increasing the total operative to postoperative exercise and dietary advice could pro-
time and was comparable to a previous study by Diamantis T bably have contributed to this observed difference. In this
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et al in which 16 ± 4.2 was documented. study, the mean preoperative body weight reduced from
The cost of surgery was found to be higher RSG 9000 139.2 to 79.6 kg at 1 year for SLSG and from 141.4 to
USD compared to 7500 USD for SLSG (ratio1.2:1). This 85.8 kg for RSG patients. Likewise, the mean preoperative
value is relatively higher than that documented in a study 19 BMI reduced from 83.8 to 30.3 among SLSG patients and
in which 400 euros was quoted. Understandably this varied 51 to 30.5 at 1 year for RSG patients. These values are also
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from center/region to center/region as some online patient in agreement with a previous study. However, the observed
information manuals quoted 9500 to 22,000 USD with an higher value of preoperative body weight/BMI for SLSG
average of 17,000 USD in the Indian subcontinent. The mean patients was contrary to findings in previous studies which
duration of hospital stay was 4.6 and 3.9 days (ratio 1.18:1) advocated use of RSG method for patients with higher
for SLSG and RSG respectively. The observation for SLSG preoperative body weight/bMI. The explanation for this
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was similar to the finding of Givon-Madhala O et al in discrepancy could be that some patients with high body
his study of 25 patients and Shi X et al in his study of 940 weight/bMI may not have been able to afford the high cost
patients. Also, a value of 3.9 days observed for RSG is within for robotic surgery in this developing or the initial learning
the range of previous studies. 17,19,20 The study differs from curve of the surgeons in the team following acquisition of

Graph 1: Summarized chart—SLSG vs RSG
Table 2: SLSG vs RSG: mean percentage excess weight loss/BMI by months
SLSG (mean BMI) RSG (mean BMI) SLSG (mean %EWL) RSG (mean %EWL)
Preop BMI 53.1 51 — —
1 month 46.5 44.9 23.4 23.7
3 months 40.8 40.8 45.1 40.8
6 months 36.7 38.3 58.9 60.0
1 year 30.3 30.5 83.8 82.0
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