Robot-assisted versus laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a propensity score-matched comparative analysis using the 2015–2016 MBSAQIP database

Abstract

Our findings show that postoperative bleeding and blood transfusion are significantly reduced with the robotic platform, and after correcting for all factors including operative time, the robotic-assisted approach is associated with better postoperative outcomes especially for RYGB.

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

“…With regard to complications, our results confirm other original papers [13,15,17,28] and meta-analysis [21,22]. Economopoulos found fewer reoperations and strictures after using the robot [21].…”

Outcomes of robotic bariatric surgery in super-obese patients: first report based on MBSAQIP database

“…More recently, our group showed a similar rate of SAE when comparing robotic and laparoscopic RYGB patients based on the more recent 2016 MBSAQIP data file [19]. Similarly, using 2015 to 2016 MBSAQIP data, Sebastian et al [16] demonstrated decreased length of stay, anastomotic leak, and renal complications for robotic RYGB patients after accounting for operative time and conversion rate. The sleeve patient cohort also showed improvement in bleeding and stricture rates with the robotic platform.…”

“…The safety of the robotic platform in bariatric surgery has been previously established [13,14]. Despite the established safety of robotics in bariatric surgery, the main disadvantages continue to be increased operating time and cost [15][16][17], as well as increased readmissions, which indicates greater resource utilization [17]. In addition, the safety and benefit of robotics in SO patients has been poorly reported, although single-institutional data with small sample sizes have shown that robotic surgery is safe in this patient population, with comparable results to both open and laparoscopic approaches [12].…”

The First Robotic Bariatric Surgery Performed in Thailand – Surgical Techniques and Review of the Literature

“…Robotic sleeve gastrectomy reduced the postoperative bleeding (0.16% vs. 0.43%; p < 0.001) and stricture (0.19% vs. 0.33%; p = 0.04) significantly when compared with traditional laparoscopic sleeve gastrectomy. 1,2,14,15 In review of the literature, no significant difference of the operative time was found between totally-robotic RYGB and laparoscopic RYGB (p = 0.42). On the other hand, there was increased operative time for roboticassisted RYGB versus laparoscopic RYGB (158.29 ± 65 vs. 120.17 ± 56; P < 0.001), and for robotic sleeve gastrectomy compared with laparoscopic sleeve gastrectomy (102.58 ± 46 vs. 73.38 ± 36; P < 0.001).…”

“…Finally, we believe that the operative time in robotic approach can be reduced once the learning curve is overcome, just as with other robotic procedures. 1,[13][14][15] Although robotic procedures seem to be more expensive than laparoscopic surgery due to initial purchase costs of the robot and the robotic instruments and accessories, as well as yearly maintenance fees that are associated with significant costs. From the University Health System Consortium (UHC) Clinical Database, the mean cost of robotic gastric bypass was $12,670, versus $10,105 for laparoscopic RYGB (p < 0.05).…”