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Updated: Jan 8, 2026
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Early Outcomes, Learning Curve and Cost Analysis of Totally Robotic Sleeve Gastrectomy
Antonio Vitiello1,2, Giovanna Berardi3, Maria Spagnuolo4
1University of Naples Federico II, Naples, Italy. antoniovitiello_@hotmail.it.
Background:
Robotic sleeve gastrectomy (RSG) is gaining adoption in metabolic bariatric surgery, yet evidence on its perioperative safety, efficiency, and costs during the early learning phase remains limited.
Objectives:
To evaluate outcomes, learning curve dynamics, and procedural costs for totally robotic sleeve gastrectomy.
Setting:
Academic center.
Methods:
A retrospective analysis was conducted of the first 53 consecutive RSGs (April 2023-July 2025) performed by a single surgeon using a standardized fully robotic technique. Perioperative variables, 30-day morbidity, and cost data were collected. Learning curves for docking time, console time, and total operative time were assessed using Cumulative Sum (CUSUM) analysis.
Results:
Mean age and BMI were 38.1 ± 12.6 years and 41.6 ± 6.3 kg/m2, respectively; 71.7% were female. Overall complication rate was 7.5% (3 bleedings, 1 leak) with no mortality or reinterventions. ICU admission and readmission each occurred in 1.9% of cases. Mean docking time was 17.8 ± 9.4 min, console time 51.5 ± 17.0 min, and total operative time 69.3 ± 18.1 min. The mean length of stay was 3.6 ± 1.1 days (range 2-10). CUSUM identified proficiency points at case 18 for docking time (- 51.1%), case 23 for console time (- 18.6%), and case 22 for total operative time (- 21.5%). Median length of stay was 3 days. Mean direct instrument/stapling cost per RSG was €4,535.
Conclusions:
Totally RSG can be introduced with safe outcomes even during the learning phase. Proficiency for operative efficiency was reached after 20 cases.
