Laparoscopic versus robotic-assisted primary bariatric-metabolic surgery. Are we still expecting to overcome the learning curve? A propensity score-matched analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database.

Aeschbacher, Pauline; Garoufalia, Zoe; Rogers, Peter; Dourado, Justin; Liang, Hong; Pena, Ana; Szomstein, Samuel; Lo Menzo, Emanuele; Rosenthal, Raul J (2024). Laparoscopic versus robotic-assisted primary bariatric-metabolic surgery. Are we still expecting to overcome the learning curve? A propensity score-matched analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surgery for obesity and related diseases, 20(9), pp. 831-839. Elsevier 10.1016/j.soard.2024.03.017

[img] Text
1-s2.0-S1550728924001242-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.
Download (372kB)

BACKGROUND

Robotic surgery is becoming increasingly popular in bariatric-metabolic surgery. However, its superiority regarding postoperative outcomes compared with conventional laparoscopy has not been clearly proven. With growing adoption of robotic surgery and improved technologies, benefits should become more evident.

OBJECTIVES

Evaluate readmission and reoperation rates after bariatric-metabolic surgery performed by conventional laparoscopy versus robotic-assisted from 2015 to 2021.

SETTING

Academic institution.

METHODS

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) was reviewed for primary bariatric operations performed with conventional laparoscopy versus robotic-assisted. Postoperative outcomes were compared in a propensity score-matched sample.

RESULTS

Of 1,059,348 cases meeting inclusion criteria, 921,322 (87%) were conventional laparoscopic bariatric-metabolic surgeries, which were matched 1:1 with robotic-assisted cases (138,026). Reoperation (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.00-1.15, P = .0463), postoperative morbidity (OR 1.07; 95% CI 1.01-1.12, P = .0193), readmission (OR 1.14; 95% CI 1.09-1.18, P < .0001), and emergency department visits (OR 1.06; 95% CI 1.03-1.09, P = .0003) at 30 days postoperatively were significantly greater for robotic-assisted cases. Robotic-assisted cases had a similar mortality rate at 30 days postoperatively and length of stay >3 days when compared with conventional laparoscopic cases. Similar results were observed in cases from 2020 to 2021, except for reoperation and emergency department visits, which showed no difference between groups and length of stay >3 days, which was greater in robotic-assisted cases.

CONCLUSIONS

Our results show a greater readmission and reoperation rate and greater morbidity at 30 days postoperatively in robotic-assisted bariatric-metabolic surgery compared with conventional laparoscopy. Analyzing only cases performed between 2020 and 2021, robotic surgery also does not show superiority over conventional laparoscopy.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

 Aeschbacher, Pauline

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 1878-7533

Publisher:

 Elsevier

Language:

 English

Submitter:

 Pubmed Import

Date Deposited:

 05 Aug 2024 13:54

Last Modified:

 01 Sep 2024 00:19

Publisher DOI:

 10.1016/j.soard.2024.03.017

PubMed ID:

 39084914

Uncontrolled Keywords:

 Bariatric surgery Conventional laparoscopic Minimal invasive surgery Postoperative outcomes Robotic surgery

BORIS DOI:

 10.48350/199432

URI:

 https://boris.unibe.ch/id/eprint/199432

Actions (login required)

Edit item Edit item
Provide Feedback