Background

A thorough evaluation of the utilization and outcomes of robotic assisted bariatric surgery (RA-BS) is needed.ObjectivesTo investigate the current utilization trends and outcomes of robotic assisted (RA-) versus laparoscopic primary bariatric surgerySettingNational Database

Methods

RA- and laparoscopic primary Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) were compared using the 2018-2021 MBSAQIP participant user data files. A total of 678,357 patients were propensity matched 1:1 based on 12 variables. 198,630 patients were included in the study group: 45,858 matched to SG and 52,772 to RYGB.

Results

From 2018 to 2021, there was an increase in the percentage of RA-BS procedures from 10% to 25%. RA-RYGB had significantly lower rates of superficial infection (0.37% vs. 0.8%), post-operative transfusion (0.75% vs. 1.1%), and gastrointestinal bleed (0.6% vs. 0.9%) compared to L-RYGB. L-SG had significantly lower rates of superficial infection (0.22% vs. 0.29%), organ space infection (0.18% vs. 0.24%), post-operative transfusion (0.46% vs. 0.68%), gastrointestinal bleed (0.19% vs. 0.26), and reoperation (0.63% vs. 0.74%) compared to RA-SG. There were statistically significant decreases in operative time, length of stay, and 30-day outcomes of reoperation, intervention, and readmission for both laparoscopic and RA-BS from 2018 to 2021.

Conclusions

There was a progressive increase in the number and percentage of RA procedures. RA-RYGB was associated with lower complication rates of infection and bleeding, while RA-SG was associated with higher rates of infection, bleeding, and reoperation. Overall, robotic approach is a safe and viable technique for bariatric surgery.