Comparison of Laparoscopic Versus Robotic Assisted Longitudinal Sleeve Gastrectomy

Nathan Miller, Erik Wilson, Brad Snyder, Phil Leggett, Terive Duperier, Terive Duperier, Todd Wilson, Kulvinder Bajwa, Nick Brown, Ben Dubois, Rachel Reeder, Sheilindra Mehta, Rich Engelhardt. UT- Houston, Bariatric Medical Institute of Texas, Houston Northwest MIS Fellowship

Introduction:
The purpose of the study was to determine the best modality to perform longitudinal sleeve gastrectomies (LSG). The number of LSG is increasing each year because of the related relative simplicity and satisfactory weight loss. The LSG is currently being performed laparoscopically, with robotic assistance, and as a single incision procedure.  Currently, there has been no comparison of these different techniques to show an advantages or disadvantages when analyzed in comparison.

Method:
A multicenter, retrospective review was performed for patients who underwent laparoscopic and robotic gastric LSG between 2005 and 2011. Comparisons were made of the incidence of complications within the 90 day global period, length of operative time, and length of hospital stay for each respective procedure. 

Results:
A total of 317 gastric sleeves where data was available were included in our review. 277 laparoscopic and 40 robotic assisted LSG) were performed in  our consortium from 2005-2011.  Overall mean operative time for all procedures was 94 minutes.   Specifically, mean operative time for lap sleeve was 91 minutes vs. 113 minutes for the robot (p=.002). Overall mean hospital stay for all procedures was 2.4 days.  Specifically, mean hospital stay for lap sleeve was 2.4 days, vs. 2.5 days for the robot (p=0.86). Overall mean 90 day complications requiring readmission was 11%. Individually,it was 12.3% for laparoscopic, and 5% in the robot assisted LSG (p=<.001).

Conclusions:
Robotic assisted LSG sleeves took significantly longer than the laparoscopic technique; whereas  robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between techniques.

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