Robotic vs. conventional laparoscopic gastric banding: a comparison of 407 cases

The current indications for using a robotic technique in bariatric surgery remain unclear. The objective of this study was to quantify the safety and potential benefits of this novel technology as compared to the conventional laparoscopic approach.

A retrospective database of patients who underwent laparoscopic adjustable gastric banding (LAGB) between December 2006 and June 2009 was examined. During this period 407 consecutive patients underwent LAGB: 287 robotically and 120 conventionally. Patient demographics, operative complications, operating times, and clinical outcomes were examined.

The patients in the robotic and conventional cohorts did not vary significantly in demographics. The prevalence of preoperative comorbidities was similar between the two groups. The rates of intraoperative and postoperative complications did not differ significantly between the two approaches. The length of postoperative hospital stay (1.3±0.6 days for both approaches) and the operating time (91.5±21.1 vs. 92.1±30.9 min for robotic and conventional, respectively) did not differ significantly between the two approaches. However, for patients with a preoperative BMI≥50 kg/m2 (n=89, 64 robotic and 25 conventional), the operating time was significantly shorter using the robotic approach (91.3±19.7 min for robotic vs. 101.3±23.7 min for conventional, p=0.04).

In this series, robotic and conventional approaches were similar in complication rates, operating time, and length of postoperative hospital stay. However, for patients with a preoperative BMI≥50 kg/m2, the operating time is significantly shorter using the robotic approach despite the adoption of this new technique. These data suggest that the robotic approach is at least as safe as the conventional laparoscopic approach in LAGB, and that the robotic approach should be considered for gastric banding candidates with BMI≥50 kg/m2.