Robotic Telerounding Reduces Postoperative Length of Stay in Uncomplicated Gastric Bypass

Lexa W Lee

April 24, 2007

April 24, 2007 (Las Vegas) — Postoperative robotic telerounding can safely reduce length of stay (LOS) in patients undergoing uncomplicated laparoscopic gastric bypass (LGBP), according to a study presented here at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons.

LOS after LGBP averages between 2 to 4 days, according to the study researchers. Robotic telepresence, which allows physicians to conduct remote patient rounds, consult with staff, and access patient data via 2-way real time streaming video, wireless protocols, and the Internet, was tested as an adjunct to standard postoperative rounds. The purpose of the study, conducted at Sinai Hospital in Baltimore, Maryland, was to assess the effect of robotic telepresence on LOS in patients after uncomplicated LGBP for morbid obesity.

The findings of a retrospective review of 376 such patients were reported by Alex Gandsas, MD, a bariatric surgeon at Sinai Hospital. Group A consisted of those patients assessed by standard bedside rounds only. Group B consisted of those assessed by a combination of remote robotic rounds and standard bedside rounds. The 2 groups were matched for age, sex, body mass index, and some comorbidities. Individuals experiencing major postoperative complications were excluded from the study.

Of the patients in group A, 218 (76%) were discharged on postoperative day 2, 48 patients (17%) on day 3, and 12 (4%) were discharged on day 4. Average LOS for patients in group A was 2.36 days. In group B, 68 patients (76%) were discharged on postoperative day 1, 18 (20%) on day 2, and 3 patients (3%) were discharged on day 3. Discharge criteria included adequate urinary output, ambulation, oral intake, and pain control. Average LOS was 1.27 days. Readmission rate within 30 days after discharge was 6% for group A and 1% for Group B.

The findings of the study indicate that postoperative robotic telerounding can safely reduce LOS in patients undergoing uncomplicated LGBP and may improve overall hospital through-put.

Dr. Gandsas remarked, "The robot is a very flexible tool. [In addition to making rounds] it can be used for teaching, it can do telemetry; it can go anywhere as long as you have a wireless signal. Such robots are being used in other countries as well."

Robert Scott, MD, a cardiologist at the Mayo Clinic in Scottsdale, Arizona, commented, "The most important thing is for people to act appropriately once they get the information [from the robots]. Telemedicine is a useful tool, but it comes down to what you do with the information; it must be directed to the right people so it can be acted upon. There's a lot of potential here for extending the reach of the medical community into areas where patients lack access to health care."

Dr. Gandsas disclosed a financial relationship with InTouch Health. Dr. Scott reports no relevant financial relationships.

SAGES 2007 Annual Scientific Session: Abstract P010. Presented April 20, 2007.