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Robotic vs. Laparoscopic Metabolic and Bariatric Surgery, Outcomes over 5 Years in Nearly 800,000 Patients

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Abstract

Introduction

Studies assessing outcomes between laparoscopic and robotic bariatric metabolic surgery (BMS) have been limited by the relatively small percentage of robotic cases. However, in recent years, the number of robotic BMS cases has doubled. We report the largest US study comparing robotic versus laparoscopic outcomes in BMS over the longest time period (5 years).

Methods

Analysis of the MBSAQIP database was undertaken. This included information on 791,423 patients from 2015–2019 in the USA. Within this retrospective case–control study, 13.7% of SG and 16.6% of RYGB cases were done robotically.

Setting

USA, MBSAQIP database.

Results

Robotic BMS increased mean operative time by 26 min for SG and 40 min for RYGB. However, this did not increase the 30-day venous thromboembolism (VTE) or organ dysfunction complications between the 2 groups. Robotic SG had slightly higher risks of multiple infectious complications (OR 1.26 to 1.76). Robotic RYGB had slightly lower infectious complications and transfusion requirements. Robotic BMS had higher 30-day readmission rates and 30-day reoperative rates for both SG and RYGB.

Conclusions

Both robotic SG and RYGB were found to have significantly longer operative times than laparoscopic SG and RYGB. Potential outcome benefits from robotic BMS can include a reduction in infectious complications and transfusion requirements with robotic RYGB cases. SGs were found to have slightly higher infectious complications.

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References

  1. “Adult Obesity Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Sept. 2021, https://www.cdc.gov/obesity/data/adult.html. Accessed 15 Mar 2022.

  2. Wilson EB, Sudan R. The evolution of robotic bariatric surgery. World J Surg. 2013;37(12):2756–60. https://doi.org/10.1007/s00268-013-2125-3.

    Article  PubMed  Google Scholar 

  3. Buchs NC, Pugin F, Azagury DE, et al. Robotic revisional bariatric surgery: a comparative study with laparoscopic and open surgery. Int J Med Robot Comput Assist Surg. 2014;10(2):213–7. https://doi.org/10.1002/rcs.1549.

    Article  Google Scholar 

  4. Bailey JG, et al. Robotic versus laparoscopic Roux-en-Y gastric bypass in obese adults ages 18 to 65 years: a systematic review and economic analysis. Surg Endosc. 2014;28:414–26. https://doi.org/10.1007/s00464-013-3217-8.

    Article  PubMed  Google Scholar 

  5. Li K, et al. Robotic versus laparoscopic bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2016;26:3031–44. https://doi.org/10.1007/s11695-016-2408-5.

    Article  PubMed  Google Scholar 

  6. Alizadeh RF, et al. Robotic versus laparoscopic sleeve gastrectomy: a MBSAQIP analysis. Surg Endosc. 2018;33:917–22. https://doi.org/10.1007/s00464-018-6387-6.

    Article  Google Scholar 

  7. Rogula T, et al. Does robotic Roux-en-Y gastric bypass provide outcome advantages over standard laparoscopic approaches? Obes Surg. 2018;28(9):2589–96. https://doi.org/10.1007/s11695-018-3228-6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Smeenk RM, Van’t Hof G, Elsten E, et al. The results of 100 robotic versus 100 laparoscopic gastric bypass procedures: a single high volume centre experience. Obes Surg. 2016;26:1266–73. https://doi.org/10.1007/s11695-015-1933-y.

    Article  CAS  PubMed  Google Scholar 

  9. Ahmad A, Carleton JD, Ahmad ZF, et al. Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital. Surg Endosc. 2016;30:3792–6. https://doi.org/10.1007/s00464-01.

    Article  PubMed  Google Scholar 

  10. Wood MH, et al. A comparison of outcomes between the traditional laparoscopic and totally robotic Roux-en-Y gastric bypass procedures. J Robotic Surg. 2014;8:29–34. https://doi.org/10.1007/s11701-013-0416-1.

    Article  Google Scholar 

  11. Moon RC, et al. Robotic Roux-en-Y Gastric Bypass, is it safer than laparoscopic bypass? Obes Surg. 2016;26:1016–20. https://doi.org/10.1007/s11695-015-1884-3.

    Article  PubMed  Google Scholar 

  12. Sebastian R, Howell MH, Chang KH, et al. Robot-assisted versus laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a propensity score-matched comparative analysis using the 2015 = 2016 MBSAQIP database. Surg Endosc. 2018;33(5):1600–12. https://doi.org/10.1007/s00464-018-6422-7.

    Article  PubMed  Google Scholar 

  13. Magouliotis DE, Tasiopoulou VS, Sioka E, et al. Robotic versus laparoscopic sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis. Obes Surg. 2017;17(1):245–53. https://doi.org/10.1007/s11695-016-2444-1.

    Article  Google Scholar 

  14. Acevedo E Jr, Mazzei M, Zhao H, et al. Outcomes in conventional laparoscopic versus robotic-assisted primary bariatric surgery: a retrospective, case–controlled study of the MBSAQIP database. Surg Endosc. 2019;34(3):1353–65. https://doi.org/10.1007/s00464-019-06915-7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 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, egistry. Surg Endosc. 2020;35(7):3915–22. https://doi.org/10.1007/s00464-020-07839-3.

    Article  PubMed  Google Scholar 

  16. 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. https://doi.org/10.1007/s11695-020-04712-z.

    Article  PubMed  Google Scholar 

  17. Pokala B, Samuel S, Yanala U, et al. Elective robotic-assisted bariatric surgery: Is it worth the money? A national database analysis. Am J Surg. 2020;220(6):1445–50. https://doi.org/10.1016/j.amjsurg.2020.08.040.

    Article  PubMed  Google Scholar 

  18. Chao GF, Montgomery JR, Abou Azar S, et al. Venous thromboembolism: risk factors in the sleeve gastrectomy era. Surg Obes Relat Dis. 2021;17(11):1905–11. https://doi.org/10.1016/j.soard.2021.06.022.

    Article  PubMed  Google Scholar 

  19. Dreifuss NH, Mangano A, Hassan C, et al. Robotic revisional bariatric surgery: a high-volume center experience. Obes Surg. 2021;31(4):1656–63. https://doi.org/10.1007/s11695-020-05174-z.

    Article  PubMed  Google Scholar 

  20. Ayloo SM, Choudhury N. Robotic revisional bariatric surgery: single-surgeon case series. Int J Med Robot Comput Assist Surg. 2015;11(3):284–9. https://doi.org/10.1002/rcs.1622.

    Article  Google Scholar 

  21. “Prospective Robotic-Assisted Revisional Bariatric Study - Full Text View.” Full Text View - ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT04506190. Accessed 15 Mar 2022.

  22. Kim MS, Kim WJ, Hyung WJ, et al. Comprehensive learning curve of robotic surgery: discovery from a multicenter prospective trial of robotic gastrectomy. Ann Surg. 2019;273(5):949–56. https://doi.org/10.1097/SLA.0000000000003583.

    Article  Google Scholar 

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    R. Wesley Vosburg, Omar Haque & Eve Roth

  2. Department of Surgery, Mount Auburn Hospital, 355 Waverley Oaks rd, suite 100, Waltham, MA, 02452, USA

    R. Wesley Vosburg

  3. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Omar Haque & Eve Roth

Authors
  1. R. Wesley Vosburg
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  2. Omar Haque
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  3. Eve Roth
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Corresponding author

Correspondence to R. Wesley Vosburg.

Ethics declarations

Statement of Informed Consent

This study was determined not to meet the criteria for human subject research. As such, informed consent was not obtained from patients for this MBSAQIP database review.

Statement of Human and Animal Rights

No human or animal subjects were used for research.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• From 2015 to 2019 the percentage of SG and RYGB done laparoscopically has been decreasing. Over the same time period the percentage of these surgeries done robotically has doubled.

• Robotic SG and RYGB are associated with significantly longer operative times than the laparoscopic counterparts.

• Robotic SG is associated with higher risk for infectious complications.

• Robotic RYGB is associated with lower infectious complications and transfusion requirements.

• Patients have a higher 30-day readmissions and reoperations for both robotic SG and RYGB

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Wesley Vosburg, R., Haque, O. & Roth, E. Robotic vs. Laparoscopic Metabolic and Bariatric Surgery, Outcomes over 5 Years in Nearly 800,000 Patients. OBES SURG 32, 2341–2348 (2022). https://doi.org/10.1007/s11695-022-06082-0

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  • DOI: https://doi.org/10.1007/s11695-022-06082-0

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