Five Year Trends in the Utilization of Robotic Bariatric Surgery Procedures, United States 2015–2019

Marroquin, Elisa Morales; Khatiwada, Shreeya; Xie, Luyu; Cruz‐Muñoz, Nestor de la; Kukreja, Sachin; Qureshi, Faisal; Messiah, Sarah

doi:10.1007/s11695-022-05964-7

Cited by 12 publications

(3 citation statements)

References 13 publications

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“…Thomas et al performed a similar study with results comparable to Tatarian et al, demonstrating a 1.96-fold increase in the number of robotic bariatric cases performed between 2015 and 2018 [ 14 ]. More recently, Morales-Marroquin et al demonstrated that between 2015 and 2019, there was an increasing trend in robotic surgery that correlated with a decline in laparoscopy [ 15 ]. Although our findings are in line with what was previously reported, our study categorized all the commonly performed MBS procedures separately (SG, RYGB, RBS, and BPD-DS) and included more recent data by incorporating the 2020 PUF in order to see whether there is a difference in the adoption rates between the different procedures.…”

Section: Discussionmentioning

confidence: 99%

Current Trends in the Utilization of a Robotic Approach in the Field of Bariatric Surgery

et al. 2022

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Purpose The utilization rate of robotic surgery for bariatric procedures is not well-described. Our study identified the proportion of metabolic and bariatric surgery (MBS) procedures in the United States between 2015 and 2020 performed using a robotic (R-) or laparoscopic (L-) approach. Materials and Methods A descriptive analysis of the 2015–2020 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant User Data File (PUF) datasets was performed. The primary outcome was (1) surgical cases performed annually and (2) proportion of cases performed using a R- or L- approach. Analysis was done separately for sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD-DS), and revisional bariatric surgery (RBS). Statistical analysis consisted of means and proportions, fold difference, annual slope, and Student’s t tests or chi-square tests as appropriate, with statistical significance set to p < .05. Results A total of 1,135, 214 procedures were captured between 2015 and 2020. R-RYGB increased from 2554 to 6198 (6.8% to 16.7%), R-SG increased from 5229 to 17,063 (6.0% to 17.2%), R-RBS increased from 993 to 3386 (4.7% to 17.4%), and R-BPD-DS increased from 221 to 393 (22.0% to 28.4%). The greatest annual increase was observed among R-RBS and R-SG (3.70-fold difference; slope 2.4% per year and 2.87-fold difference; slope 2.2% per year, respectively). Conclusion There is a nationwide increase in the utilization of a R- approach in bariatric surgery. There are concerns related to the potential increase in healthcare expenditures related to robotics. Further studies are needed to establish key performance indicators along with guidelines for training, adoption and utilization of a R- approach. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Current Trends in the Utilization of a Robotic Approach in the Field of Bariatric Surgery

et al. 2022

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“…The global adoption of robotic surgery continues to rise in different surgical specialties like colorectal [ 1 – 3 ], urology [ 4 , 5 ], bariatrics [ 6 – 8 ], upper gastrointestinal [ 9 – 11 ] and gynecology [ 12 – 14 ]. While a large proportion of the robotic systems currently installed are the well-established da Vinci robotic surgical system (Intuitive Surgical Inc, California, USA), various manufacturers have developed and introduced alternative robotic systems.…”

Section: Introductionmentioning

confidence: 99%

Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes

Leang,

Kong,

Mosharaf

et al. 2024

J Robotic Surg

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Multiple novel multi-port robotic surgical systems have been introduced into clinical practice. This systematic review aims to evaluate the clinical outcomes of these novel robotic systems to conventional laparoscopic technique and established da Vinci robotic surgical platforms. A literature search of Embase, Medline, Pubmed, Cochrane library, and Google Scholar was performed according to the PRISMA guidelines from 2012 to May 2023. Studies comparing clinical outcomes of novel multi-port robotic surgical systems with laparoscopic or the da Vinci platforms were included. Case series with no comparison groups were excluded. Descriptive statistics were used to report patient and outcome data. A systematic narrative review was provided for each outcome. Twelve studies comprised of 1142 patients were included. A total of 6 novel multi-port robotic systems: Micro Hand S, Senhance, Revo-i MSR-5000, KangDuo, Versius, and Hugo™ RAS were compared against the laparoscopic or the da Vinci robotic platforms. Clinical outcomes of these novel robotic platforms were comparable to the established da Vinci platforms. When compared against conventional laparoscopic approaches, the robotic platforms demonstrated lower volume of blood loss, shorter length of stay but longer operative time. This systematic review highlighted the safe implementation and efficacy of 6 new robotic systems. The clinical outcomes achieved by these new robotic systems are comparable to the established da Vinci robotic system in simple to moderate case complexities. There is emerging evidence that these new robotic systems provide a viable alternative to currently available robotic platforms.

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“…As an effective treatment [ 2 ], bariatric surgery is performed primarily via a laparoscopic approach, accounting for roughly 90.4% of all bariatric cases [ 3 ]. A slow adoption of robotic-assisted surgery (RAS) has been observed in bariatric surgery [ 3 , 4 ], in contrast to rapid adoption within other specialties (e.g., gynecology and urology) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying Workflow Disruptions in Robotic-Assisted Bariatric Surgery: Elucidating Challenges Experienced by Surgical Teams

et al. 2023

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Purpose Bariatric surgery is an effective and durable treatment for weight loss for patients with extreme obesity. Although traditionally approached laparoscopically, robotic bariatric surgery (RBS) has unique benefits for both surgeons and patients. Nonetheless, the technological complexity of robotic surgery presents new challenges for OR teams and the wider clinical system. Further assessment of the role of RBS in delivering quality care for patients with obesity is necessary and can be done through a human factors approach. This observational study sought to investigate the impact of RBS on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. Materials and Methods RBS procedures were observed between October 2019 and March 2022. FDs were recorded in real time and subsequently classified into one of nine work system categories. Coordination FDs were further classified into additional sub-categories. Results Twenty-nine RBS procedures were observed at three sites. An average FD rate of 25.05 (CI = ± 2.77) was observed overall. FDs were highest between insufflation and robot docking ( M = 29.37, CI = ± 4.01) and between patient closing and wheels out ( M = 30.00, CI = ± 6.03). FD rates due to coordination issues were highest overall, occurring once every 4 min during docking ( M = 14.28, CI = ± 3.11). Conclusion FDs occur roughly once every 2.4 min and happen most frequently during the final patient transfer and robot docking phases of RBS. Coordination challenges associated with waiting for staff/instruments not readily available and readjusting equipment contributed most to these disruptions. Graphical abstract

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Five Year Trends in the Utilization of Robotic Bariatric Surgery Procedures, United States 2015–2019

Cited by 12 publications

References 13 publications

Current Trends in the Utilization of a Robotic Approach in the Field of Bariatric Surgery

Current Trends in the Utilization of a Robotic Approach in the Field of Bariatric Surgery

Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes

Identifying Workflow Disruptions in Robotic-Assisted Bariatric Surgery: Elucidating Challenges Experienced by Surgical Teams

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