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Outcomes of Robotic-Assisted Bariatric Surgery Compared to Standard Laparoscopic Approach Using a Standardized Definition: First Look at the 2020 Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) Data

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Abstract

Purpose

The primary objective of this study is to evaluate the outcomes of robotic-assisted (RA-) approach compared to the standard laparoscopic (L-) approach using the 2020 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) registry Public Use File (PUF). Our secondary objective is to establish standards for the reporting of outcomes using PUF.

Materials and Methods

Using the PUF database (n = 168,568), patients were divided into sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), revisions, and conversions and then analyzed separately. We created balanced covariate through propensity score matching and inverse probability treatment weighting (IPTW). We also conducted multivariable relative risk regression to confirm our results.

Results

For RYGB, the incidence of “transfusion” was significantly lower in the RA-RYGB compared to the L-RYGB. There was no significant difference in the rate of Serious Event Occurrences (SEOs) or rate of intervention at 30 days. For SG, there was a higher rate of “transfusion” in the RA group. Incidence of SEOs was also significantly higher in the RA-group. There was no significant difference in SEOs for conversions; however, revisions had a trend toward a lower rate of SEOs favoring the robotic approach. Operative times were significantly higher for all RA-groups.

Conclusion

RA- approach in metabolic and bariatric surgery (MBS) remains controversial because of differences in outcomes. The use of SEOs as reported by MBSAQIP in its semi-annual report can be used as a composite score to assess outcomes while using PUF. Further studies are needed to compare RA- to L- MBS.

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Data Availability

The MBSAQIP program and the hospitals participating in the MBSAQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Authors and Affiliations

  1. Department of Surgery, St Luke’s University Hospital and Health Network, 1736 Hamilton Street, Allentown, PA, 18104, USA

    Maher El Chaar

  2. Geisinger Clinic, 100 N Academy Ave, Danville, PA, 17821, USA

    Anthony Petrick

  3. Texas Tech Health Sciences Cente School of Medicine, 4801 Alberta Ave, El Paso, TX, 79905, USA

    Benjamin Clapp

  4. St Luke’s University Hospital and Health Network, 801 Ostrum Street, Bethlehem, PA, 18015, USA

    Jill Stoltzfus

  5. Texas Tech University Health Sciences Center, 4801 Alberta Ave, El Paso, TX, 79905, USA

    Luis A. Alvarado

Authors
  1. Maher El Chaar
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  2. Anthony Petrick
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  3. Benjamin Clapp
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  4. Jill Stoltzfus
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  5. Luis A. Alvarado
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Corresponding author

Correspondence to Maher El Chaar.

Ethics declarations

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Informed consent does not apply.

Conflict of Interest

Maher El Chaar, speaker and proctor for Intuitive. Ben Clap, nothing to disclose. Anthony petrick, nothing to disclose. Luis Alvarado, nothing to disclose. Jill Stoltzfus, nothing to disclose. This manuscript was not supported financially by any external funding or grants.

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Key points

1. Data comparing the outcomes of robotic-assisted (RA-) and laparoscopic (L-) metabolic and bariatric surgery (MBS) based on MBSAQIP PUF is inconsistent because of lack of standardized outcome reporting measures.

2. The purpose of the manuscript was to compare the outcomes of RA- to L- MBS using a standardized definition as defined by the MBSAQIP risk-adjusted semi-annual reports.

3. For RYGB, there was no difference in the rate of serious event occurrences (SEOs) for RA- and L- groups despite a lower “transfusion rate” in the RA-group. For SG, there was a higher rate of SEOs in the RA-group because of higher “transfusion” rate.

4. Revisions had a trend toward a lower rate of SEOs favoring the robotic approach.

Appendix A

Appendix A

Table 14 Severe event occurrences (SEOs) for Roux-en-Y gastric bypass
Full size table
Table 15 Severe event occurrences (SEOs) for sleeve gastrectomy
Full size table
Table 16 Severe event occurrences (SEOs) for conversions
Full size table
Table 17 Severe event occurrences (SEOs) for revisions
Full size table

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El Chaar, M., Petrick, A., Clapp, B. et al. Outcomes of Robotic-Assisted Bariatric Surgery Compared to Standard Laparoscopic Approach Using a Standardized Definition: First Look at the 2020 Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) Data. OBES SURG 33, 2025–2039 (2023). https://doi.org/10.1007/s11695-023-06585-4

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