Comparative Study of Single Incision, Robotic, and Stadard Laparoscopic Sleeve Gastrectomy

Harvey C Rainville, MD, Kulmeet Sandhu, MD, Brad Snyder, MD, Pratibha Vemulapali, MD, Emmanuel Agaba, MD, Diego Camacho, MD. Montefiore Medical Center, University of Texas Health Science Center

Introduction: Advanced minimally invasive techniques including robotic and single incision laparoscopic surgery (SILS) are being increasingly utilized in the field of Bariatric Surgery.  These techniques appear to be effective alternatives to the standard laparoscopic sleeve gastrectomy, currently one of the most commonly performed bariatric operations.  We were interested in comparing these techniques to one another and to the standard laparoscopic sleeve gastrectomy in terms of perioperative complications, operative time, and length of stay.

Methods: We performed a multi-institution retrospective study comparing the use of robotic and SILS techniques to the standard laparoscopic sleeve gastrectomy.  The study included 20 SILS, 11 robotic, and 50 traditional laparoscopic sleeve gastrectomies.  The patients demographics and comorbidities were standardized with respect to the traditional laparoscopic group.  We then focused on comparing operative time, perioperative complications, conversion rates and length of stay.

Results: All of the operations performed using the advanced techniques were performed successfully without the need for conversion.  There were two patients who required the placement of an additional port in the SILS group.  The operative times were increased for both the SILS and robotic groups.  There was no increase in operative blood loss, length of stay or perioperative complications in the hospital or at the initial follow up.

Conclusion:  The use of robotic and SILS techniques to perform sleeve gastrectomies are safe and comparable alternatives to the standard laparoscopic technique. 

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