ROBOTIC VERSUS LAPAROTMY ACCESS OUTCOMES FOR SIMULTANEOUS PYLOROPLASTY AND GASTRIC STIMULATOR IMPLANTATIPON FOR GASTROPARESIS
Brian R. Davis, Jonathan Gevorkian*, Mohammad Bashashati, Mishaal Ali, Alyssa Greenwood Francis, Irene Sarosiek, Richard W. McCallum
Texas Tech Health Sciences Center E, El Paso, TX
Background: Gastroparesis (GP) affects up to 10 million individuals in the US. Symptomatic improvement in GP refractory to medical therapy treated with gastric electrical stimulation (GES) ranges from 50-60%. GES has minimal effect on gastric emptying. Additional surgical pyloroplasty (PP) has improved symptom resolution in up to 70%. Simultaneous GES and PP proves safe and effective with minimal long-term complications. The purpose of this study is to compare perioperative outcomes of robot-assisted versus laparotomy for simultaneous pyloroplasty and GES implantation.
Methods: This is a retrospective review of peri-operative outcomes from patients who underwent pyloroplasty and GES implantation between 2012 to 2022. GES implantation and Heineke-Mikulicz PP were performed by either robot-assisted surgery (RS) or laparotomy. Perioperative outcomes include duration of surgery, complications, and duration of hospitalization were analyzed. Data is presented as mean ± SEM or frequency (%). Statistical comparison was performed using t-test or Chi-square.
Results: Patients underwent robotic surgery (45) or laparotomy (13). Twenty-seven (60%) and 11 (85%) of respective groups were women. In RS and laparotomy groups, 36 (80%) and nine (69%) were diabetic. Duration of surgery was significantly shorter in the laparotomy group (p<0.001). Blood loss in the RS group was lower than laparotomy (57.4 mL vs 77.7 mL). Average days of hospitalization for the RS group were shorter (p<0.05). In the RS group, time to initiate liquid diet (p<0.05) and gastroparesis diet (p<0.05) were significantly shorter. In the RS group, the time of cessation of I.V. narcotics, was shorter (p<0.001).
Conclusion: Simultaneous pyloroplasty and gastric stimulator implantation in drug refractory gastroparesis can be safely recommended. Robotic access demonstrates improved peri-operative outcomes compared to laparotomy.
Back to 2023 Posters