• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Robot-Assisted versus Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A Propensity Score-Matched Comparative Analysis of 118,313 cases using the 2015-MBSAQIP.

Raul Sebastian1, Melanie Howell2, Ambar Mehta2, Gina Adrales2, Alisa Coker2, Thomas Magnuson2, Michael Schweitzer2, Hien T Nguyen2. 1George Washington, 2Johns Hopkins

Introduction: Robotic-assisted bariatric surgeries are part of the armamentarium currently available in many bariatric centers. Limited data is available regarding the comparative effectiveness of robotic and laparoscopic approaches. This study compares 30-day outcomes between robotic-assisted and laparoscopic procedures for two bariatric surgeries: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Methods: Using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, patients >18-60 years old were included. Demographic data, comorbidities, operative variables, and 30-day outcomes were compiled for patients undergoing RYGB and SG. To adjust for potential baseline confounders, 1:1 propensity-score matching (PSM) was performed using 18 comorbid conditions. Second PSM analysis was performed to adjust for operative time and conversion rate. Statistical analysis was performed before and after PSM.

Results: A total of 118,313 patients were selected: 81,960 patients underwent SG and 36,353 patients underwent RYGB After propensity score-matched analysis, Robotic Assisted Sleeve Gastrectomy (RSG) and Laparoscopic Sleeve Gastrectomy (LSG) cohorts evaluated 5,201 matched cases while Robotic Assisted Roux-en-Y Gastric Bypass (RRYGB) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) evaluated 2,552 matched cases.

Regardless of procedure performed, the operative time was significantly longer in the Robotic assisted cases (RSG 104+/-45 vs LSG 75+/-37, p<0.0001 and RRYGB 156+/-63 vs LRYGB 119+/-57, p<0.0001). However, In the RYGP cohort, the robotic approach showed significantly less requirements for blood transfusions (RRYGB 0.51% vs LRYGB 1.37%, P=0.002). The two methods were similar in the other evaluated 30-day outcomes. When analyzing the SG cases, reoperations (RSG 1.31% vs LSG 0.65%, p=0.001), need for additional interventions (IR drainage, UGI, endoscopy) (RSG 1.69% vs LSG 0.96% p=0.002) and conversion rate (RSG 0.71% vs LSG 0.10%, p<0.0001) were significantly higher in the Robotic group. Also, shorter hospital stay was associated with the laparoscopic approach (LSG 1.69+/-1.76 vs RSG 1.78+/-1.94 p<0.0001). Conversely, when adding operative time and conversion rate to the PSM analysis, the RRYGP group showed significantly shorter length of stay (RRYGB 2.17+/-2.18 vs LRYGB 2.29+/-2.66, p <0.001). In this second analysis, the significance in hospital duration disappeared within the SG group (RSG 1.78+/-1.94 vs LSG 1.84+/-2.25, p=0.13).

Conclusions: RRYGP is safe, and has similar outcomes to LRYGP in terms of perioperative complications, with significantly reduced blood transfusions with RRYGP.  Although operative time for robotic cases was longer, there was a strong correlation between shorter operative time and decreased hospital length of stay, especially in RRYGP.  


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87812

Program Number: S102

Presentation Session: Robotics 2 Session

Presentation Type: Podium

16

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons