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. 2021 Feb;31(2):854-861.
doi: 10.1007/s11695-020-05055-5. Epub 2020 Nov 9.

Trends in Utilization and Perioperative Outcomes in Robotic-assisted Bariatric surgery using the MBSAQIP database: A 4-Year Analysis

Thomas Scarritt  1 , Chiu-Hsieh Hsu  2 , Felipe B Maegawa  1 , Alfonso E Ayala  1 , Matthew Mobily  1 , Iman Ghaderi  3
Affiliations

Trends in Utilization and Perioperative Outcomes in Robotic-assisted Bariatric surgery using the MBSAQIP database: A 4-Year Analysis

Thomas Scarritt et al. Obes Surg. 2021 Feb.

Abstract

Purpose: Robotic-assisted surgery has become increasingly popular across surgical subspecialties. We aimed to analyze trends in the national utilization and outcomes in bariatric surgery.

Materials and methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) data for 2015-2018 was queried. We included robotic-assisted sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), biliopancreatic diversion with duodenal switch (BPD-DS), and revisional cases. The Kruskal-Wallis test or Wilcoxon rank-sum were used for comparing continuous variables and Cochran-Armitage trend analysis for categorical variables when comparing years, or with Fisher's Exact Test when directly comparing categories.

Results: Of 760,076 bariatric cases performed between 2015 and 2018, 7.4% with robotic and 90.4% with laparoscopic approach. SG constituted 61.3% of robotic volume. Utilization of robotic surgery increased 1.96-fold; SG represented the most substantial increase of 2.16-fold, followed by a 1.53-fold in RYGB. The 30-day readmission and re-intervention rates decreased from 5.63% to 4.78% (p<0.01), and 2.31% to 1.46% (p<0.01), respectively. The overall leak rate improved from 0.64% to 0.39% (p=0.01). Mortality and re-operations remained statistically unchanged. When compared to laparoscopic approach, the operative time were significantly longer in the robotic group. Regarding postoperative outcomes, when adjusted for patient characteristics, there were no differences between two approaches except a higher leak rate in robotic group in 2015.

Conclusion: A steady increase in robotic bariatric surgery is apparent. While the operative time remains significantly longer in the robotic group, trends indicate improvement in key quality metrics and patient outcomes as utilization increases.

Keywords: Bariatric surgery; Robotic surgery; laparoscopic; outcomes; short-term complications.

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References

    1. George EI, Brand TC, LaPorta A, et al. Origins of Robotic Surgery: From Skepticism to Standard of Care. JSLS. 2018;22(4)
    1. Himpens JLG, Cadiere GB. Telesurgical laparoscopic cholecystectomy. Surg Endosc. 1998;
    1. Leal Ghezzi T, Campos Corleta O. 30 Years of Robotic Surgery. World J Surg. 2016;40(10):2550–7. - DOI
    1. Stewart CL, Ituarte PHG, Melstrom KA, et al. Robotic surgery trends in general surgical oncology from the National Inpatient Sample. Surg Endosc. 2019;33(8):2591–601. - DOI
    1. Jayakumaran J, Patel SD, Gangrade BK, et al. Robotic-assisted laparoscopy in reproductive surgery: a contemporary review. J Robot Surg. 2017;11(2):97–109. - DOI

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