Table 3.
Benchmark cut-offs (75th percentile of centres’ median) for low-risk (benchmark) and high-risk (non-benchmark) robotic Roux-en-Y gastric bypass compared with the previously established global benchmark cut-offs for laparoscopic Roux-en-Y gastric bypass4
| Surgical approach | Robotic | Laparoscopic | |
|---|---|---|---|
| Perioperative course | Low risk (n = 895) | High risk (n = 2835) | Low risk (n = 4120) |
| Operation duration (min) | ≤162 | ≤167 | ≤120 |
| Docking time (min) | ≤13.5 | ≤10 | – |
| Console time (min) | ≤140 | ≤144 | – |
| Conversion to laparoscopic or open surgery | 0 | ≤0.04 | 0 |
| Intraoperative or postoperative blood transfusions | 0 | ≤1 | ≤2 |
| Hospital stay (days) | ≤2 | ≤2.2 | ≤4 |
| Readmission until 90 days | ≤5.6 | ≤7.4 | ≤5.5 |
| Morbidity and mortality | Until discharge | Until 30 days | Until 90 days | ||||
|---|---|---|---|---|---|---|---|
| Low risk (n = 895) | High risk (n = 2835) | Low risk (n = 895) | High risk (n = 2835) | Low risk (n = 895) | High risk (n = 2835) | Laparoscopic Low risk (n = 4120) | |
| Uneventful postoperative course | >97.5 | >93.5 | >90.3 | >84 | >88.2 | >80 | >90 |
| Any complication | ≤2.5 | ≤6.5 | ≤9.7 | ≤16 | ≤11.8 | ≤20 | ≤10 |
| Complication CD grade II | ≤1.7 | ≤3.7 | ≤4.8 | ≤4.9 | ≤5 | ≤6 | ≤4.1 |
| Complication CD grade ≥IIIa | ≤1.4 | ≤3.2 | ≤4.2 | ≤5.3 | ≤5 | ≤6.7 | ≤5.5 |
| Reoperation (CD grade IIIb) | ≤1.4 | ≤1.4 | ≤2.5 | ≤3.2 | ≤4.3 | ≤4 | ≤4 |
| ICU admission (CD grade IV) | ≤0.8 | ≤1.1 | ≤0.8 | ≤1.2 | ≤0.9 | ≤1.2 | 0 |
| Mortality (CD grade V) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| CCI® | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| CCI® (in patients with ≥1 CD grade ≥II complication) | ≤33.73 | ≤39.56 | ≤33.73 | ≤39.56 | ≤34.81 | ≤39.56 | ≤33.73 |
| Complications | |||||||
| Anastomotic leak | ≤0.8 | ≤0.3 | ≤1.4 | ≤1.2 | ≤1.4 | ≤1.2 | ≤1.3 |
| Motility disorder | 0 | 0 | ≤0.9 | ≤2.2 | ≤1.9 | ≤3.5 | – |
| Postoperative bleeding | ≤0.9 | ≤1 | ≤1.3 | ≤1.5 | ≤1.3 | ≤1.5 | ≤2.2 |
| Small bowel obstruction/internal hernia | 0 | ≤0.4 | ≤0.9 | ≤1.6 | ≤2.5 | ≤1.9 | ≤2.1 |
| Wound infection | 0 | ≤0.2 | ≤0.8 | ≤0.7 | ≤0.9% | ≤0.9 | ≤0.5 |
| Dysphagia/gastro-oesophageal reflux disease/stenosis | 0 | 0 | ≤1.4 | ≤1.4 | ≤2 | ≤2.8 | – |
| Abdominal or osteo-articular pain | 0 | 0 | 1.3 | ≤1 | ≤1.9 | ≤1.5 | – |
| Deep-vein thrombosis/pulmonary embolism | 0 | 0 | ≤0.6 | ≤0.6 | ≤0.7 | ≤0.7 | – |
| Marginal ulcer | 0 | 0 | ≤0.1 | 0 | ≤0.4 | ≤1 | ≤1.5 |
Values are % unless otherwise indicated. CD, Clavien–Dindo; CCI®, comprehensive complication index.