Robotic-Assisted Bariatric Surgery Compared to Standard Laparoscopy-Utilization Trends, Outcomes, and Operative...

Area of Science:

• Bariatric Surgery
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Robotic-assisted bariatric surgery (RA-BS) utilization and outcomes require evaluation.
• This study compares robotic-assisted (RA) versus laparoscopic primary bariatric surgery trends and outcomes.

Purpose of the Study:

• To investigate current utilization trends of RA-BS versus laparoscopic bariatric surgery.
• To compare perioperative outcomes between RA and laparoscopic primary bariatric procedures.

Main Methods:

• Utilized 2018-2021 MBSAQIP data for RA and laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).
• Propensity matched 198,630 patients (1:1) based on 12 variables.
• Included 145,858 matched for SG and 52,772 for RYGB.

Main Results:

• RA-BS procedures increased from 10% to 25% between 2018-2021.
• Laparoscopic sleeve gastrectomy (L-SG) showed lower infection, transfusion, bleeding, and reoperation rates than robotic-assisted sleeve gastrectomy (RA-SG).
• Robotic-assisted Roux-en-Y gastric bypass (RA-RYGB) demonstrated lower infection, transfusion, and bleeding rates compared to laparoscopic RYGB (L-RYGB).
• Both laparoscopic and RA-BS showed decreased operative times and improved 30-day outcomes (reoperation, intervention, readmission) over time.

Conclusions:

• RA-BS procedures show a progressive increase in utilization.
• Most perioperative outcomes were statistically equivalent between RA and laparoscopic approaches.
• RA-RYGB was linked to reduced infection and bleeding complications, whereas RA-SG had higher rates of infection, bleeding, and reoperation.
• Further research is necessary to clarify the efficacy and clinical significance of RA-BS.