Long-Term Outcomes and Safety of Robotic Bariatric Surgery

Bariatric surgery (BS) is the most effective treatment for sustained weight loss and improvement of obesity-related comorbidities. Robotic BS (RBS) offers enhanced precision and ergonomics; however, local data remain limited.

This retrospective real-world study included consecutive adults (≥18 years) who underwent single-surgeon robotic-assisted primary BS using the da Vinci® Surgical System (October 2012-December 2024), with complete perioperative and follow-up data.

A total of 545 patients were analyzed with a mean age of 42.98 ± 11.15 years and a mean body mass index (BMI) of 44.55 ± 6.66 kg/m²). Sleeve gastrectomy (SG) was the most common procedure (72.48%), followed by Roux-en-Y gastric bypass (RYGB, 17.61%) and one-anastomosis gastric bypass (OAGB, 9.91%). Mean docking and operative times were 6.25 ± 2.29 and 99.84 ± 29.21 minutes, respectively. Intraoperative events were infrequent (console-related 2.57%, bedside-related 4.04%, instrument-related 3.12%), with no conversions. Mean intensive care unit (ICU) and hospital stays were 0.25 ± 0.45 and 2.42 ± 0.56 days. Thirty-day complications occurred in 2.02% of patients, comprising grade I (1.10%), grade II (0.73%), and grade III (0.18%) events. Between 1 month and 1 year, 1.28% experienced minor (grade I) complications. At 1 year, mean BMI decreased to 32.68 ± 4.02 kg/m², with no mortality. Outcomes in patients with BMI ≥ 50 kg/m² were comparable, supporting the safety and feasibility of RBS in grade IV obesity.

RBS proved safe, efficient, and effective, with low complications and consistent outcomes, supporting its use for obesity management in high-volume centers.