Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass

Robotic-assisted surgery has been described for many general surgery procedures, including gastric bypass. This is a comparative study looking at the short-term outcomes and technical differences between laparoscopic Roux-en-Y gastric bypass (LRNY) and robotic-assisted Roux-en-Y gastric bypass (RARNY). Our database was reviewed for all Roux-en-Y gastric bypass procedures performed over the last 5 years. Operative times, length of stay, and all complications listed for the 90 days postoperatively were recorded and statistically analyzed. A total of 356 LRNY and 249 RARNY were performed. The average body mass index (BMI), age, and sex were similar between groups. On average, the RARNY took 17 min longer than the LRNY, this difference being significant (p < 0.01). Average length of stay for the two groups was similar (~3 days). There were a total of 51 complications in the standard laparoscopic group (14%), of which 14 (3.9%) were major complications. In the robotic group, there were 35 (14%) complications, of which 9 (3.6%) were major complications. The only significant difference in complication rate was for anastomotic leak at the gastrojejunostomy: there were no leaks in the robotic series, and six (1.7%) in the standard laparoscopic series (p = 0.04). Length of stay and overall complication rates were similar for RARNY and LRNY. There was no mortality in either group, and the complication rate was lower than literature standards. While the RARNY took longer, there was a significantly lower gastrointestinal leak rate in this group.