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- Title
Is Robotic Revisional Bariatric Surgery Justified? An MBSAQIP Analysis.
- Authors
Seton, Tristan; Mahan, Mark; Dove, James; Villanueva, Hugo; Obradovic, Vladan; Falvo, Alexandra; Horsley, Ryan; Petrick, Anthony; Parker, David M.
- Abstract
Background: The laparoscopic approach is utilized in greater than 90% of bariatric surgeries. With the growing prevalence of robotic-assisted surgery in bariatrics, there has been limited consensus on the superiority of either laparoscopic or robotic approaches, especially in revisional procedures (conversion from sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB)). Methods: A retrospective analysis was performed of the MBSAQIP PUF database of patients who underwent conversion from SG to RYGB procedures in either laparoscopic or robotic-assisted approaches. The groups underwent 2:1 propensity matching and primary outcomes included post-conversion days until discharge (POD), conversion operation length, total and major morbidity, 30-day readmission, 30-day reoperation, 30-day reintervention, and 30-day mortality after conversion. Results: After 2:1 propensity score matching, 3411 patients (2274 laparoscopic vs 1137 robotic) were included in the study. Intraoperatively, no significant difference was found in total morbidity (6.5% lap vs 5.9% robotic) or major morbidity (1.9% lap vs 1.7% robotic); however, the operative times were significantly longer robotically (126 min vs 164 min). Post-operatively, no significant differences were found in discharge day (1.8 lap vs 1.8 robotic), 30-day readmission (7.6% lap vs 8.6% robotic), reoperation rate (2.9% lap vs 3.7% robotic), additional intervention rate (2.5% lap vs 3.3% robotic), or 30-day mortality (0.1% vs 0.1%). Conclusion: There is no significant difference in perioperative or intraoperative outcomes between laparoscopic and robotic-assisted SG to RYGB conversion procedures other than a longer operative time in the robotic approach, suggesting increased efficiency with the laparoscopic approach.
- Subjects
BARIATRIC surgery; GASTRIC bypass; PROPENSITY score matching; SLEEVE gastrectomy; ROBOTICS
- Publication
Obesity Surgery, 2022, Vol 32, Issue 12, p3863
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-022-06293-5