Abstract
Robotic surgery is an increasingly popular alternative to laparoscopy for performing bariatric operations. To describe changes in utilization and complication rates of this technique over the last six years an analysis of the 2015–2020 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program participant use files (MBSAQIP PUF) was performed. All patients who underwent laparoscopic or robotic bariatric surgery from 2015 to 2020 were included. 1,341,814 robotic and laparoscopic bariatric operations were included. Both the number and proportion performed robotically increased from 2015 (n = 9866, 5.87%) to 2019 (n = 54,356, 13.16%). In 2020, although the number of cases decreased, the proportion performed robotically still increased (17.37%). Yet, there has been no significant change in 30 day risk of death (p = 0.946) or infection (p = 0.721). In fact, the risk of any complication has decreased from 8.21% in 2015 to 6.43% in 2020 (p = 0.001). Robotic cases are being increasingly performed on high-risk patients with 77.06% of patients being American Society of Anesthesiologists (ASA) class 3 or higher in 2015 versus 81.03% (p = 0.001) in 2020. Robotic cases are also more likely to be revision operations than laparoscopic cases (12.16% vs 11.4%, p = 0.001). From 2015 to 2020 robotic bariatric surgery became more prevalent yet both complication rates and length of operation decreased suggesting it is an increasingly safe option. The risk of robotic complications remains higher than laparoscopy, however there are significant differences in the patient populations suggesting there may be specific patients and/or operations in which robotic bariatric surgery is being used.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AL, MG and EK. The first draft of the manuscript was written by EK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Koeller, E., Luhrs, A.R. & Giorgi, M. Changes in utilization of robotic bariatric surgery and effect on patient outcomes from 2015–2020. J Robotic Surg 17, 2041–2045 (2023). https://doi.org/10.1007/s11701-023-01611-0
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DOI: https://doi.org/10.1007/s11701-023-01611-0