P106 Robotic Roux-en-Y gastric bypass: A systematic review to examine reporting of a surgical innovation

Introduction

Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures, and robotic methods are increasingly used. Perceived benefits of robotic surgery include improved visualisation and ergonomics, fewer complications, and shorter hospital stay. Rigorous processes that facilitate the safe transition of surgical innovations such as robotic RYGB into clinical practice are currently lacking. This may place patients at risk, and lead to research waste. The IDEAL Collaboration has produced guidance on the reporting of surgical innovations, but it is not known how robotic RYGB has been reported. This project aims to summarise technique description, governance arrangements and outcome reporting in robotic RYGB.

Methods

A systematic review is being conducted, using PRISMA guidance. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed to identify primary studies reporting outcomes of robotic RYGB. Data will be extracted on study characteristics, governance and ethical arrangements, descriptions of technique, and outcomes. The data will be evaluated in relation to IDEAL principles.

Results

The literature search yielded 1012 studies; 754 remained after de-duplication. Following screening by abstract, 229 full texts were screened. 67 studies will undergo extraction of data. A descriptive summary of the data will be presented, with a critique of the findings.

Conclusion

This study will summarise and appraise how robotic RYGB has been reported. This will contribute towards the development of a standardised and methodical process for the introduction of surgical innovation into clinical practice.

Chronic rhinosinusitis with polyposis and serum vitamin D levels

The pathogenesis of chronic rhinosinusitis (CRS) is still unknown, but it is accepted that various inflammatory factors are responsible for the different CRS subtypes. Vitamin D3 has been shown to alter inflammatory mediators in some diseases and its deficiency might also be associated with CRS with nasal polyposis (CRSwNP). Herein, we investigated serum vitamin D3 levels in patients with CRSwNP and its association with disease severity. In a cross-sectional study, 166 cases with CRSwNP and 172 healthy subjects were enrolled. Serum vitamin D3 levels were measured and compared in both groups. Furthermore, the relationship between serum vitamin-D3 level and the patient’s allergic status and severity of disease (clinically and based on computed tomographic imaging and nasal endoscopy) among patients with CRSwNP was assessed. Serum vitamin D3 level in the CRSwNP group was significantly lower than in the control group (P < 0.0001). After controlling for possible confounding factors, an increase in vitamin D level showed a protective effect in CRSwNP (OR = 0.69 95% CI:0.62-0.76). A negative correlation was found between serum vitamin-D3 level and the Lund-Mackay score (LMS) (P < 0.0001, R = – 0.66), the Lund-Kennedy score (LKS) (P < 0.0001, R = – 0.71) and the Sino-Nasal Outcome Test-22 (P < 0.001, R = – 0.49). Serum vitamin D level in the CRSwNP group was significantly lower than the control group. Disease severity, based on imaging, endoscopic and clinical criteria, was inversely associated with serum vitamin D levels.