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Understanding the Current Role of Robotic-Assisted Bariatric Surgery

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Abstract

Background

The role of robotic surgery in bariatrics remains controversial. Patient selection for robotic surgery is not well-studied. The objective of this study was to identify factors associated with robotic surgery and its temporal trends.

Methods

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database from 2015 to 2018 was used. Adult patients undergoing primary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) using the laparoscopic or robotic approach were identified. Revisional, hybrid, or those with concomitant procedures were excluded. Logistic regression was conducted to identify factors associated with undergoing robotic-assisted surgery.

Results

Among 211,568 patients who underwent SG, 9.1% underwent a robotic SG; among 76,805 patients who underwent RYGB, 7.9% of patients underwent a robotic RYGB. During 2015-2018, robotics increased from 7.1 to 11.3% for SG and 7.4 to 8.6% for RYGB. After controlling for patient characteristics, there was still an increasing trend in the use of robotic surgery: SG (multivariable-adjusted odds ratio, aOR, 1.18; 95% confidence interval, CI, 1.17–1.20) and RYGB (aOR, 1.05; 95% CI, 1.03–1.08). For both robotic SG and RYGB, functional status and African American race were associated with undergoing robotic surgery, while races other than White or African American and Hispanic ethnicity were not. Pre-operative IVC filter was associated with robotic SG, while the presence of GERD, diabetes, and COPD were associated with robotic RYGB.

Conclusions

Robotic bariatric surgery has increased over time. Our findings identified factors associated with the receipt of robotic surgery. Reasons for these factors require further investigation to better delineate indications for this technology.

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Authors and Affiliations

  1. Department of Surgery, Washington University in Saint Louis School of Medicine, 660 South Euclid Ave Campus Box 6109, Saint Louis, MO, 63110, USA

    Francesca M. Dimou, Dawn Freeman, J. Christopher Eagon & Shaina R. Eckhouse

  2. Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA

    Nicole Ackermann & Su-Hsin Chang

Authors
  1. Francesca M. Dimou
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  2. Nicole Ackermann
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  3. Su-Hsin Chang
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  4. Dawn Freeman
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  5. J. Christopher Eagon
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Correspondence to Francesca M. Dimou.

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Dimou, F.M., Ackermann, N., Chang, SH. et al. Understanding the Current Role of Robotic-Assisted Bariatric Surgery. OBES SURG 31, 3130–3137 (2021). https://doi.org/10.1007/s11695-021-05375-0

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  • DOI: https://doi.org/10.1007/s11695-021-05375-0

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