Robotic versus laparoscopic sleeve gastrectomy: a MBSAQIP analysis

Area of Science:

• Bariatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Laparoscopic sleeve gastrectomy (LSG) is the standard surgical treatment for morbid obesity.
• Robotic sleeve gastrectomy (RSG) is an emerging alternative with limited utilization.
• This study compares the outcomes of RSG and LSG using national data.

Purpose of the Study:

• To evaluate and compare the contemporary outcomes of robotic sleeve gastrectomy (RSG) versus laparoscopic sleeve gastrectomy (LSG).
• To identify differences in operative time, length of stay, mortality, and morbidity between RSG and LSG.
• To inform surgical decision-making for sleeve gastrectomy procedures.

Main Methods:

• Analysis of the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.
• Inclusion of patients who underwent sleeve gastrectomy, excluding emergent and revisional cases.
• Multivariate logistic regression analysis to compare outcomes between RSG and LSG groups.

Main Results:

• A total of 75,079 sleeve gastrectomies were analyzed (93.6% LSG, 6.4% RSG).
• RSG had a significantly longer operative time (102 vs. 74 minutes) and higher rates of serious morbidity, leaks, and surgical site infections compared to LSG.
• No significant difference in 30-day mortality or length of stay was observed between the two groups.

Conclusions:

• Robotic sleeve gastrectomy is associated with increased operative time and higher postoperative morbidity, including leaks and surgical site infections.
• Laparoscopic sleeve gastrectomy demonstrates superior safety and efficiency.
• Laparoscopy should remain the preferred surgical approach for sleeve gastrectomy.