Suburban Community Hospital Feasterville Trevose, PA, United States
Vishal Chandel, MD1, Imran Khokhar, MD1, Sharique Nazir, MD2 1Suburban Community Hospital, Norristown, PA; 2New York University School of Medicine, Brooklyn, NY
Introduction: Sleeve gastrectomy remains an effective means of addressing obesity and obesity-related complications. While bariatric procedures have been primarily performed laparoscopically over the past few decades, there has been increasing interest in robotic bariatric surgery (RBS). The emergence of robotic surgery has demonstrated efficacy in non-bariatric procedures. As technology continues to improve, it is important to compare this new modality to conventional approaches.
Methods: We performed a single center, retrospective review sampling data for year 2019. We compared robotic and laparoscopic sleeve gastrectomies using parameters like average operating times, costs, length of stay, complications along with review current literature.
Results: Data was extrapolated from 18 robotic sleeve gastrectomies (RSG) and 17 laparoscopic sleeve gastrectomies (LSG). Average operating time for RSG was 114.6 minutes compared to LSG which was 68.9 minutes. Average intraoperative costs were similar with RSG compared to LSG. Average LOS was 1.44 days for RSG compared to 1.76 days for LSG. There were no 30 day readmissions or serious complications in either group.
Discussion: Both RBS and LBS demonstrated satisfactory weight loss results, resolution of various obesity related comorbidities at follow-up. Our data, and current literature, support that RBS and LBS have comparable outcomes and complications. Operative time and hospital cost may be increased with RBS; however, it is our belief that with improvements in robotic technology and procedural skills, both cost and time should improve. Several literature reviews have compared RBS and laparoscopic bariatric surgery (LBS) and have concluded that clinical outcomes and complications are similar between the two. However, RBS is associated with longer operative times and higher net costs. It has been suggested that the robotic platform may be more beneficial in complex cases, although current literature does not necessarily demonstrate this. Acevedo et al. examined laparoscopic versus robotic-assisted revisional bariatric surgery and concluded that RBS was associated with longer operative times and higher rates of complications. In a similar review examining primary laparoscopic versus robotic-assisted bariatric surgery, Acevedo et al. demonstrated that robot assisted gastric bypass has lower morbidity and mortality. However, this was not demonstrated for the sleeve gastrectomy. Overall they concluded that both robotic sleeve and gastric bypass are very safe.
Figure: Comparison of Robotic and Laparoscopic procedures in obesity management: preoperative and preoperative data
Vishal Chandel indicated no relevant financial relationships.
Imran Khokhar indicated no relevant financial relationships.
Sharique Nazir indicated no relevant financial relationships.
Vishal Chandel, MD1, Imran Khokhar, MD1, Sharique Nazir, MD2. P1949 - Comparative Analysis of Robotic and Laparoscopic Sleeve Gastrectomy in Obesity Management: Institutional Study and Review of Literature, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.