Abstract
Purpose
Robotic approaches have been steadily replacing laparoscopic approaches in metabolic and bariatric surgeries (MBS); however, their superiority has not been rigorously evaluated. The main goal of the study was to evaluate the 5-year utilization trends of robotic MBS and to compare to laparoscopic outcomes.
Methods
Retrospective analysis of 2015–2019 MBSAQIP data. Kruskal-Wallis test/Wilcoxon and Fisher’s exact/chi-square were used to compare continuous and categorical variables, respectively. Generalized linear models were used to compare surgery outcomes.
Results
The use of robotic MBS increased from 6.2% in 2015 to 13.5% in 2019 (N= 775,258). Robotic MBS patients had significantly higher age, BMI, and likelihood of 12 diseases compared to laparoscopic patients. After adjustment, robotic MBS patients showed higher 30-day interventions and 30-day readmissions alongside longer surgery time (26–38 min).
Conclusion
Robotic MBS shows higher intervention and readmission even after controlling for cofounding variables.
Graphical Abstract
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References
Jung MK et al. Robotic bariatric surgery: a general review of the current status. The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS. 2017;13(4). https://doi.org/10.1002/rcs.1834.
Pernar LIM, Robertson FC, Tavakkoli A, et al. An appraisal of the learning curve in robotic general surgery. Surg Endosc. 2017;31(11):4583–96
Tatarian T, Yang J, Wang J, et al. Trends in the utilization and perioperative outcomes of primary robotic bariatric surgery from 2015 to 2018: a study of 46,764 patients from the MBSAQIP data registry. Surg Endosc. 2021;35(7):3915–22
Scarritt T, Hsu CH, Maegawa FB, et al. Trends in utilization and perioperative outcomes in robotic-assisted bariatric surgery using the MBSAQIP database: A 4-Year Analysis. Obes Surg. 2021;31(2):854–61
Li K, Zou J, Tang J, et al. Robotic versus laparoscopic bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2016;26(12):3031–44
Zhang Z, Miao L, Ren Z, Li Y. Robotic bariatric surgery for the obesity: a systematic review and meta-analysis. Surg Endosc. 2021;35(6):2440–56
Dudash M, Kuhn J, Dove J, et al. The longitudinal efficiency of robotic surgery: an MBSAQIP Propensity matched 4-year comparison of robotic and laparoscopic bariatric surgery. Obes Surg. 2020;30(10):3706–13
Lundberg PW, Wolfe S, Seaone J, et al. Robotic gastric bypass is getting better: first results from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Surg Obes Relat Dis. 2018;14(9):1240–5
Surgery ACoSaASoMaB. Metabolic and bariatric surgery accreditation and quality improvement program. Available at: https://www.facs.org/quality-programs/mbsaqip. Accessed 1 Oct 2021.
Surgery ACoSaASoMaB. User guide for the 2018 participant use data file (PUF). Available at: https://www.facs.org/-/media/files/quality-programs/bariatric/mbsaqip_2018_puf_userguide.ashx. Accessed 1 Oct 2021.
El Chaar M, King K, Salem JF, et al. Robotic surgery results in better outcomes following Roux-en-Y gastric bypass: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program analysis for the years 2015-2018. Surg Obes Relat Dis. 2021;17(4):694–700
Michalsky MP et al. Cardiovascular risk factors after adolescent bariatric surgery. Pediatrics. 2018;141(2):e20172485. https://doi.org/10.1542/peds.2017-2485.
Husain F, Jeong IH, Spight D, et al. Risk factors for early postoperative complications after bariatric surgery. Ann Surg Treat Res. 2018;95(2):100–10
Nickel F, de la Garza JR, Werthmann FS, et al. Predictors of risk and success of obesity surgery. Obes Facts. 2019;12(4):427–39
Funding
This work was supported by the National Institute on Minority Health and Health Disparities [grant R01MD011686].
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Contributions
EMM conceived the research idea, wrote the first draft of the manuscript, and worked on authors’ and reviewers’ feedback. SK and LX analyzed the data and created the tables. LX also contributed with manuscript revisions. SEM obtained the database, reviewed and edited the manuscript, and oversaw the analysis. NDLCM, SK, FGQ, and BS reviewed and edited the manuscript. All authors approved of the final version of the manuscript.
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For this type of study formal consent is not required.
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Conflict of Interest
Dr. de la Cruz (surgeon) has received funds from Intuitive Surgical Inc. for education purposes since 2019. Dr. de la Cruz’ relationship with Intuitive Surgical Inc. has been reviewed by the University of Miami, Florida in accordance with its conflict of interest policies. Dr. Kukreja (surgeon) is a consultant and key opinion leader for Intuitive Surgical Inc. since 2019. All other authors report no conflicts of interest.
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Key Points
• Two hundred and seventeen percent higher utilization of robotic metabolic and bariatric surgeries between 2015 and 2019.
• First article to stratify by year and bariatric surgery type the time invested in robotic procedures.
• After adjustment, 30-day intervention and readmissions remained higher in the robotic MBS group.
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Morales-Marroquin, E., Khatiwada, S., Xie, L. et al. Five Year Trends in the Utilization of Robotic Bariatric Surgery Procedures, United States 2015–2019. OBES SURG 32, 1539–1545 (2022). https://doi.org/10.1007/s11695-022-05964-7
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DOI: https://doi.org/10.1007/s11695-022-05964-7