Background

Staple line buttressing (SLB) in laparoscopic sleeve gastrectomy (LSG) has previously been shown to decrease the risk of post-operative bleeding from the gastric staple line. In robotic sleeve gastrectomy (RSG), SLB is often not used. With the increasing popularity of robotic surgery in bariatrics, this study seeks to compare the risk of bleeding complications between RSG and LSG.

Methods

We retrospectively reviewed electronic medical records of 927 patients at a single academic center between June 2021 and August 2023. 575 patients underwent RSG without SLB and 371 patients underwent LSG with SLB. We looked at the 30-day post-operative complications focusing on transfusion requirements and re-operation for bleeding as indicators of a bleeding complication.

Results

The average BMI of the cohort was 43.05 kg/m2 (RSG 43, LSG 43.12, p=0.01), average age 39.4 (RSG 39.3, LSG 39.4, p= 0.88) and 74% were females (RSG 75%, LSG 69.8%). 40% of patients were ASA class II (RSG 40%, LSG 38.5%) and 59% were ASA class III (RSG 57.6%, LSG 59.3%). No patients required a reoperation for bleeding. No RSG patients required a transfusion. 2 patients required transfusion in LSG cohort. Both of these complications resulted in an extended length of stay of 6.1 and 1.9 days. One patient also suffered a staple line leak.

Conclusions

This study demonstrates there is no increased risk of bleeding complications with RSG without staple line buttressing compared to LSG with staple line buttressing.