Eric S Wise, MD1, Eric H Mace, BS2, M. Katie Hanisee, MD1, Jessica M Felton, MD1, NIkhil Prasad, MBChB1, Yash A Choksi, MD2, Nabeel Zafar, MD1, Mark D Kligman, MD1. 1University of Maryland Medical Center, 2Vanderbilt University School of Medicine
Objective: Robotic assistance for bariatric surgery represents a novel application of a rapidly emerging technology. Its safety and efficacy remains primarily characterized by smaller, single-institution studies. In this investigation, the influence of robotic assistance on short-term perioperative outcomes is contrasted with the more established primary multi-port laparoscopic approach for patients undergoing Roux-en-Y gastric bypass (RYGB), using data from a national bariatric database.
Methods: A retrospective analysis of 2,976 robotic-assist and 38,716 laparoscopic RYGB patients from the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database were reviewed for differences in patient characteristics and short-term outcomes. On bivariate analysis, variables associated with primary outcomes of 30-day reoperation, readmission and reintervention were imputed into multivariate analyses to determine independent significance.
Results: Robotic-assist bypass patients were older (P<.001), had a higher prevalence of comorbidities and had concomitant operations more frequently performed during surgery (P<.001). On bivariate analysis, robotic-assist patients had a higher rate of readmission than laparoscopic patients (7.5% vs. 6.4%; P=.03), but no differences in 30-day reoperation (2.7% vs. 2.5%; P=.63), reintervention (3.3 vs. 2.7, P=.08), or mortality (0.13% vs. 0.18%; P=.82) were observed. Multivariate analysis failed to demonstrate differences between robotic-assist and laparoscopic patients in any of the primary endpoints (P>.05).
Conclusion: Robotic-assistance does not confer an increased rate of morbidity and mortality after RYGB, and represents a feasible surgical modality for the surgeon willing to adopt the technology and accept its limitations.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88356
Program Number: P417
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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