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Operative Time and 30-Day Outcomes in Bariatric Surgery: Comparison between Robotic and Laparoscopic Approach: 4-Year

Katherine Ho1, Chiu-Hsieh Hsu, Felipe Maegawa

  • 1From the University of Arizona Medical Center - University Campus, Banner University Medical Center, Tucson, AZ.

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Robotic bariatric surgery shows comparable outcomes to laparoscopic surgery, despite longer operative times. Robotic approaches also reduce variability in operative time, enhancing surgical consistency.

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Area of Science:

  • Bariatric Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Longer operative time (OT) is a primary criticism of robotic surgery.
  • Understanding OT determinants and outcomes is crucial for robotic surgery adoption.
  • This study focuses on robotic vs. laparoscopic approaches in bariatric surgery.

Purpose of the Study:

  • Examine variables affecting operative time (OT) in bariatric surgery.
  • Assess the association between OT and 30-day patient outcomes.
  • Evaluate the impact of robotic surgery compared to laparoscopic surgery on outcomes.

Main Methods:

  • Analysis of MBSAQIP data from 2016-2019.
  • Logistic regression to analyze OT and outcomes, adjusting for patient characteristics.
  • Comparison of robotic and laparoscopic approaches across sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch.

Main Results:

  • Robotic surgery had longer OT than laparoscopic surgery (p < 0.0001).
  • Longer OT correlated with increased adverse 30-day outcomes across both approaches.
  • Postoperative outcomes were comparable, with robotic surgery showing lower reoperation/readmission rates in specific procedures.

Conclusions:

  • Robotic bariatric surgery outcomes are comparable to laparoscopic surgery, even with longer OT.
  • Robotic surgery significantly decreases the variability in operative time.
  • Robotic approach offers potential benefits in reducing variability and specific adverse outcomes.