Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Aug;34(8):2954-2964.
doi: 10.1007/s11695-024-07368-1. Epub 2024 Jul 18.

Robotic-Assisted and Laparoscopic Bariatric Surgeries Still Have Clinically Comparable Outcomes

Clay L Cashman  1 , Swapnil V Shah  1 , Alexander G Hall  2 , Ryan W Walters  2 , Kalyana C Nandipati  3
Affiliations
Comparative Study

Robotic-Assisted and Laparoscopic Bariatric Surgeries Still Have Clinically Comparable Outcomes

Clay L Cashman et al. Obes Surg. 2024 Aug.

Abstract

Purpose: Bariatric surgery is considered the main treatment option for patients with severe obesity. The objective of our study is to compare intra- and postoperative outcomes between the robotic and laparoscopic approaches within the sleeve gastrectomy (SG), duodenal switch (DS), and Roux-en-Y gastric bypass (RYGB).

Materials and methods: The data from the MBSAQIP were collected for patients who underwent SG, DS, and RYGB between 2015 and 2021. The postoperative and procedural outcomes including 30-day morbidity and mortality as well as operation length were analyzed using regression models.

Results: Our analysis included 1,178,886 surgeries with SG comprising the majority (70%) followed by RYGB (28%) and DS (1%). Other than a higher adjusted risk of unplanned reoperation for robotic RYGB (relative risk (RR) 1.07) and a statistically significant higher rate of postoperative wound disruption in robotic SG for robotic surgery (RR 1.56), there were no statistically significant between-approach differences including infection, wound disruption, death, or reoperation for DS, RYGB, or SG. Our data showed no significant difference in anastomotic leak rate between laparoscopic and robotic approaches in either the DS (p = 0.521) or RYGB (p = 0.800) procedures. Across our study period, the median operation lengths decreased significantly per year for both the robotic SG and DS.

Conclusions: Robotic and laparoscopic bariatric surgical procedures have statistically similar 30-day patient outcomes. Robotic bariatric procedures do have significantly longer median operative times than laparoscopic procedures. The decision to use a robotic approach or laparoscopic approach should be made based upon surgeon experience and possibly cost.

Keywords: Bariatric surgery; Duodenal switch; Gastric bypass; MBSAQIP; Robotic surgery; Sleeve gastrectomy; Weight loss surgery.

PubMed Disclaimer

Conflict of interest statement

Clay L. Cashman, Swapnil V. Shah, Alexander G. Hall, and Ryan W. Walters — no conflict of interest. Kalyana C. Nandipati — proctor for Intuitive Surgical. The authors declare that they have no conflict of interest with the current project.

Figures

Fig. 1
Fig. 1
Median observed operation length in minutes (top) and unplanned reoperation rate in percent (bottom) between robotic and laparoscopic approaches by year for each procedure. Operation length and unplanned reoperation over time. DS, duodenal switch; RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. (2022, May 17). Adult obesity facts. Retrieved August 28, 2022, from https://www.cdc.gov/obesity/data/adult.html
    1. Mayo Foundation for Medical Education and Research. (2021, September 18). Bariatric surgery. Mayo Clinic. Retrieved August 28, 2022, from https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-....
    1. Jung MK, Hagen ME, Buchs NC, et al. (2017). Robotic bariatric surgery: a general review of the current status.Int J Med Robotics Comp Assisted Surg, 13(4). 10.1002/rcs.1834 - PubMed
    1. Fazl Alizadeh R, Li S, Inaba CS, et al. Robotic versus laparoscopic sleeve gastrectomy: a MBSAQIP analysis. Surg Endosc. 2019;33:917–22. 10.1007/s00464-018-6387-6. 10.1007/s00464-018-6387-6 - DOI - PubMed
    1. Sebastian R, Howell MH, Chang KH, et al. Robot-assisted versus laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a propensity score-matched comparative analysis using the 2015–2016 MBSAQIP database. Surg Endosc. 2019;33:1600–12. 10.1007/s00464-018-6422-7. 10.1007/s00464-018-6422-7 - DOI - PubMed

Publication types

LinkOut - more resources