Reza Fazl Alizadeh, MD, Marcelo W Hinojosa, MD, Brian R Smith, MD, FACS, Michael J Stamos, MD, FACS, Ninh T Nguyen, MD, FACS. University of California, Irvine School of Medicine
INTRODUCTION: Laparoscopic sleeve gastrectomy has become the procedure choice in the treatment of morbid obesity. Robotic sleeve gastrectomy is an alternative surgical option but it’s utilization continues to be low. The aim of this study was to evaluate the contemporary outcomes of robotic sleeve gastrectomy (RSG) vs. laparoscopic sleeve gastrectomy (LSG) using a national database from accredited centers.
METHODS AND PROCEDURES: Using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, clinical data were obtained for all patients who underwent RSG vs. LSG. Emergent and revisional cases were excluded. Multivariate logistic regression model was utilized to compare the outcomes of RSG vs. LSG.
RESULTS: A total of 86,953 patients were identified including 93.9% LSG and 6.1% RSG. Preoperative sleep apnea and hypoalbumenia were significantly higher in RSG patients (P<0.05). Mean length of stay was similar between RSG and LSG (1.8±2 vs. 1.7±2 days, respectively, P=0.17). Compared to LSG, RSG patients had significantly higher mean operating time (101±42 min vs. 74±35 min, P<0.01). Following risk adjustment, there was no significant difference for in-hospital mortality (0.01% vs. 0.02%, respectively, AOR: 0.89, 95% CI: 0.12-6.76, P=0.91) and overall morbidity (1.8% vs. 1.6%, respectively, AOR: 1.15, 95% CI: 0.93-1.42, P=0.18) rates between the two groups. However, RSG patients had higher risk of leak (1.5 % vs. 0.5%, AOR: 3.14, 95% CI: 2.47-4.0, P<0.01) and surgical site infections (0.8 % vs. 0.6%, AOR: 1.38, 95% CI: 1.01-1.89, P=0.03).
CONCLUSION(S): Robotic sleeve gastrectomy increases hospital resources including longer operative time and had a higher risk for postoperative morbidity including leak and surgical site infections. These findings may explain the low utilization rate of the robotic approach to sleeve gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87416
Program Number: S024
Presentation Session: Bariatrics 1 Session
Presentation Type: Podium
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