Robotic Versus Laparoscopic Gastric By Pass Treat Obesity:a Meta-analysis

Objectives:1?Explore the safety and feasibility of da Vinci robotic Roux-en-Y gastric bypass surgry.2?To compare the short-term effects of Robotic and laparoscopic Roux-en-Y gastric bypass surgry.Methods:Pubmed,EMBASE,medline,The China National Knowledge Infrastructure,VIP(Jan,2010 till Oct,2016)were searched to collect the articles that compare curative effect of robotic gastric bypass surgery and laparoscopic gastric bypass.The data were analyzed by the RevMan 5.2 sofeware.11 articles were include in this study.There were 3366 patients in total: 1356 robotic versus 2010 laparoscopic.Results:1? Anastomotic leak: Analysis of this eleven articles,I~2=48%,P=0.06,Heterogeneity is not obvious,Using the fixed effects model,The analysis results show:[OR=0.60,95% CI:(0.34,1.04),P=0.07]?2? Anastomotic stricture: Analysis of this eleven articles,eight of the paper describe the anastomotic stricture,I~2=35%,Heterogeneity is not obvious,Using the fixed effects model,The analysis results show: [OR=0.01,95% CI:(-0.02,0.01)P=0.31]?3? Overall complication: Analysis of this eleven articles,I~2=0%,Heterogeneity is not obvious,Using the fixed effects model,The analysis results show: [OR=0.74,95% CI:(0.59,0.93)P=0.010]?4? Reoperation: Analysis of this eleven articles,seven of the paper describe the reoperation.I~2=0%,Heterogeneity is not obvious,Using the fixed effects model,The analysis results show: [OR=0.25,95%CI:(0.11,0.56)P=0.0008]?5? Open conversion: Analysis of this eleven articles,I~2=0%,Heterogeneity is not obvious,Using the fixed effects models.The analysis results show: [OR=0.20,95% CI:(0.09,0.44),P<0.00001]?6? Operation time:Analysis of this eleven articles,I~2=96%,Heterogeneity is obvious,Using the random effects models.The analysis results show: [WMD=17.83,95% CI:(-3.48,39.15)P=0.1]7? The hospital stays: Analysis articles,I~2=46%,Heterogeneity is not obvious,Using the fixed effects model,The analysis results show: [SMD=-0.30,95% CI:(-0.39,-0.20),P<0.00001]?Conclusion:1? There is no significant difference in anastomotic leak between robotic gastric bypass and laparoscopic gastric bypass.2? The meta-analysis showed no difference in Anastomotic stricture between robotic gastric bypass surgery and laparoscopic gastric bypass surgery.3? The robotic gastric bypass have advantages to laparoscopic gastric bypass in overall complication.4? Robotic gastric bypass has a low reoperation rate than laparoscopic gastric bypass.5? Robotic gastric bypass has a low open conversion rate than laparoscopic gastric bypass.6? There are not statistically significant difference between the two group,and Heterogeneity is obvious,we can not consider the operation time of robotic gastric bypass has advantage to laparoscopic gastric bypass.7? The hospital stay of robotic gastric bypass is shorter than which by laparoscopic gastric bypass.Robotic gastric bypass had lower complication rate?reoperation rate and less hospital stay than laparoscopic gastric bypass surgery.Therefore,we can consider that robotic gastric bypass accomplish the Roux-en-Y gastric bypass surgery is safe and feasible,and have newer advantage in technique than laparoscopic surgery.