The purpose of this study is to gather clinical and economic evidence on the use of robotics for bariatric surgery (gastric bypass). This monocentric, randomized, single blind, controlled study will evaluate post-operative pain, quality of life and appetite, post-operative complication incidence. It will also provide information on direct and indirect costs of surgery.
Robot-assisted Surgery Versus Conventional Laparoscopy in Bariatric Surgery (Gastric Bypass): a prospective, single-blind, randomized, non-inferiority, and controlled study The main evaluation criterion is 24h post-operative pain assessed using visual analog scale (VAS). Secondary criteria included for clinical assessment: post 24h pain, excess weight loss, quality of life, appetite, complications, conversion rate; and for health-economics assessment : duration of surgical steps, length of stay, return to normal activity and their conversion to cost, consumables, estimation of indirect costs and benefits (e.g., robotics perception, publication). In this study, main inclusion criteria include major obesity (IMC ≥ 35) with co-morbidities or morbid obesity (IMC ≥ 40), scheduled gastric bypass surgery Main contraindications are previous bariatric surgery and previous major abdominal surgeries To test robotic-assisted surgery non-inferiority on VAS pain score 24h post-surgery, a total of 128 patients (64 per arm) is to be included (alpha 2,5%; power 90%; drop-out rate: 5%). The study will include 12 months of follow-up post-surgery for each patient. The total study duration is 2 years and 3 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
118
Gastric bypass
Service de Chirurgie Digestive et Endocrinienne
Strasbourg, France
24h postoperative pain
Pain assessment 24h post surgery (visual analog scale)
Time frame: 24h
Evaluation of post-operative pain
Evaluation of post-operative pain (beyond 24h post-operative) using VAS
Time frame: 24h, 8 days, 1, 3, 6 and 12 months
Evaluation of quality of life (BAROS and GIQLI)
Evaluation of quality of life using BAROS and GIQLI questionaires
Time frame: At 1, 3, 6 and 12 months
Evaluation of appetite level
Evaluation of appetite level using VAS
Time frame: At 8 days, 1, 3, 6 and 12 months
Percentage of excess weight loss
Measure of excess weight loss - % from baseline
Time frame: At 8 days, 1, 3, 6 and 12 months
Conversion rate to conventional laparoscopy
Conversion rate to conventional laparoscopy (only applicable to robot-assisted surgery arm)
Time frame: During the procedure (Day 0)
Nature of per-operative complications
Nature of per-operative complications
Time frame: During the procedure (Day 0)
Nature of post-operative complications
Nature of post-operative complications
Time frame: Following the procedure (Day 0) up to 12 months
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Evaluation of operative times
Evaluation of key steps of gastric bypass surgery, OR occupation time
Time frame: During the procedure (Day 0)
Evaluation of direct costs
Direct costs include material used, OR occupation time, length of stay, return to normal activity
Time frame: During the procedure (day 0) and up to 12 months
Evaluation of indirect costs
Combination of number of patients having surgery, perception of robot-assisted surgery by both personnel and patients, publications, and communications
Time frame: Up to 12 months