Background

It was suggested that Robotic Assisted (RA-) approach may offer an advantage compared to standard Laparoscopic (L-) approach in high Body Mass Index (BMI) categories.PurposeThe objective of this study is to evaluate the outcomes of RA- to L- approach using 2020-2022 Metabolic and Bariatric Surgery Accreditation and Quality Improvement (MBSAQIP) registry Public Use Files (PUF) based on BMI.Materials and Methods Using MBSAQIP database 2020-2022 (n=513191), patients were divided into sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) then analyzed separately using our previously reported standardized outcomes. We employed propensity score matching and created five balanced subgroups based on BMI cutoffs with multivariable Relative Risk (RR) regression to confirm our results.

Results

For RYGB, there was no significant difference in Severe Event Occurrences (SEOs) between RA- and L- approaches across all BMI categories. Intervention at 30 days was higher in the RA- group for the BMI 30-34.9 subgroup. For SG, incidence of SEOs was significantly higher in the RA-approach for all BMI subgroups except for BMI 30-34.9 and >=50. Readmission within 30 days was higher with RA- for BMI 35-39.9 subgroup. Hospital length of stay was significantly shorter in all BMI subgroups for both RA-SG and RA-RYGB.

Conclusions

Our analysis showed no significant difference in SEOs between RA- and L-RYGB based on different BMI categories. L-SG have significantly lower rates of SEOs compared to RA-SG across all BMI categories except for 30-34.9 and >=50.