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Single-surgeon Transition From Laparoscopy to Robotic-assisted Bariatric and General Surgery: Throughput, Operative
1El Paso Bariatrics, El Paso, Texas.
Background:
The operational impact of transitioning from laparoscopic to robotic surgery is incompletely characterized, particularly regarding throughput and nonconsole operative time.
Methods:
We analyzed 1664 consecutive cases performed by a single surgeon (2023-2026), comparing laparoscopic (n=632) and robotic eras (n=1032). Throughput, operative time, and robotic OR overhead (skin-to-skin minus console time) were assessed using EMR, MBSAQIP, and vendor-derived data sources.
Results:
Weekly case volume increased from 9.54 to 11.36 (+19.1%), with stable OR days and increased cases per OR day (+17%). Robotic cases had longer operative times (SG +14.0 min; RYGB +27.6 min, P<0.001). The mean robotic OR overhead was ~19 minutes and consistent across independent data sources. Over time, overhead decreased by 30% (23.2 to 16.3 min; P<0.001), demonstrating improved efficiency.
Conclusions:
Transition to robotic surgery increased throughput despite longer operative times. Robotic OR overhead is substantial but declines with experience, suggesting recoverable efficiency gains over time.
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