Page 6 - Journal of Laparoscopic Surgery
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RF Ijah et al
          complications were the measures of outcome studied in  Frezza EE et al report of duration of 1 day   and 28 days
          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
          was longer than SLSG. There was a wide variation in time  similar to previous studies which reported 47 to 83%  and
          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
          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
          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
          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
          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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