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Background

Robotic-assisted surgery (RAS) has emerged as an alternative to laparoscopic surgery (LAP) for Roux-en-Y Gastric Bypass (RYGB), offering several advantages. This study aimed to compare the perioperative outcomes of RAS and LAP for RYGB.

Methods

A retrospective cohort study was conducted using PINC AITM (Premier healthcare) hospital discharge database from 2020-21. The study included adult patients with BMI >=30 kg/m2, undergoing elective RYGB surgery done either through RAS or LAP in an inpatient setting. Patients with revisional procedures were excluded. RAS and LAP cohorts were matched through 1:1 propensity scoring with covariates including patient demographics, comorbidities, hospital, and physician characteristics.

Results

The final sample included 5,326 patients in each cohort. RAS-RYGB patients had lower bleeding related complications 30-days post-surgery (0.2% vs 0.3%), conversions to open surgery (0.4% vs 0.9%), admissions to the Intensive Care Unit (ICU) (1.4% vs 2.2%), shorter length of stay (median 1 vs 2 days), fewer post-operative visits to the hospital at 90-days post-surgery (33% vs 35%) compared to LAP-RYGB (p<0.05). RAS-RYGB patients had higher rates of post-operative 30-days bowel obstruction and operating time. However, high-volume surgeons (n=316, conducting >=125 procedures annually) performing RAS- and LAP-RYGB had similar post-operative bowel obstructions and lower operating times.

Conclusions

Patients who underwent RAS-RYGB demonstrated better peri-operative outcomes in terms of bleeding related complications post-surgery, conversions, and ICU admissions than LAP-RYGB. When performed by experienced surgeons, RAS-RYGB demonstrates lower operating times and equivalent post-operative bowel obstructions as LAP-RYGB.