Background

Robotics is increasingly utilized in bariatric surgery, but there is little experience or data in a safety-net hospital setting and patient population. Prior studies have also suggested worse outcomes associated with lower socioeconomic factors and public insurance.

Methods

To compare outcomes of a new robotic sleeve gastrectomy program at a public, safety net hospital (RSG-SN) with those undergoing laparoscopic sleeve gastrectomy at the same center (LSG-SN) and at an affiliated private hospital (LSG-PH).Participants508 patients were identified (21 underwent RSG-SN, 118 underwent LSG-SN and 369 in the LSG-PH group). Inpatient and outpatient outcomes including the percent excess weight-loss (%EWL) was compared between groups.

Results

There was no significant difference in patient demographics or comorbidities between RSG-SN and either LSG group, including age, gender, body mass index, and race/ethnicity. RSG-SN was associated with a significantly shorter length of stay compared to LSG-SN (1.4 vs. 2.2 days; p<0.01), with no leaks, conversions to open, or reoperations. Operative times, reoperation rates, readmission rates, and complications showed no significant differences. Compared to the LSG-PH cohort, RSG-SN had slightly longer OR times (+10mins, P<0.05) but with no difference in hospital stay or postoperative complications. Weight loss was statistically equivalent in all 3 cohorts at 6 and 12 months, with the highest %EWL seen with RSG-SN (Fig., p=NS).

Conclusions

A pilot robotic sleeve gastrectomy program initiated at a public safety-net hospital demonstrated shorter hospital stays and equal outcomes compared to LSG at both the same center and the affiliated private hospital.