(C-138) Utilization of a Knotless Tissue Control Device for Robotically-assisted Hand-sewn Gastrojejunal Anastomosis in Roux-en-Y gastric Bypass: A Retrospective Analysis of Real-world Data

Background: Recent increases in the utilization of robotic assistance for Roux-en-Y gastric bypass (RYGB) have led to a commensurate increase in complete robotically-assisted hand-sewn gastrojejunal anastomosis; currently, there is a paucity of data on the post-operative outcomes of patients undergoing RYGB in which STRATAFIX Spiral Knotless Tissue Control Devices (KTCD; Ethicon, Inc.) were used for this task.

Objectives: To examine post-operative outcomes of patients undergoing RYGB in which KTCD were used for robotically-assisted hand-sewn gastrojejunal anastomosis.

Methods: Using the U.S. PINC AI Healthcare Database, we identified candidate hospitals in which robotically-assisted RYGB was performed with use of KTCD between 01/01/2016-9/30/2022 (first RYGB=index); candidate hospitals were approached to verify that KTCD were used for the complete hand-sewn gastrojejunal anastomosis and invited to participate in a retrospective chart review. Outcomes included mortality at index, anastomotic leakage and bleeding, bleeding of unspecified origin, and intra-abdominal infection within 30 days post-index, as well as reoperation, readmission, and anastomotic strictures within 90 days post-index.

Results: A total of 145 patients in 2 hospitals from one health system (age range: 20-69y; 81.4% female) met the study selection criteria. There was no inpatient mortality at index and no anastomotic leakage, anastomotic bleeding, or intra-abdominal infection within 30 days/90 days post-index. Eleven patients had anastomotic strictures within 90 days post-index. There were no cases of reoperations. Twelve patients were readmitted for various reasons within 90 days post-index, including 2 patients for anastomotic stricture.

Conclusions: In this retrospective chart review of 145 patients undergoing robotically-assisted RYGB, we found no instances of major surgical complications after the use of KTCD for complete hand-sewn gastrojejunal anastomosis.