Robot-assisted vs laparoscopic bariatric procedures in super-obese patients: clinical and economic outcomes

• DOI: 10.1007/s11701-023-01748-y
• Publication Date: 2024-01-17T12:02:16Z
• Authors: Giuseppe Marincola; Priscilla Frances...; Francesco Pennestrì; Pierpaolo Gallucci; Nikolaos Voloudakis; Luigi Ciccoritti; Francesco Greco; Giulia Salvi; Francesca Prioli; Carmela De Crea; Marco Raffaelli
• Keywords: Sleeve gastrectomy; Quadrant (abdomen)

Abstract The increased operative time and costs represent the main limitations of robotic technology application to bariatric surgery. Robotic platforms may help surgeon overcome technical difficulties in super-obese (SO, BMI ≥ 50 kg/m 2 ) patients, which multi-quadrant operations could be challenging. We aimed evaluate effect robot-assisted (R) versus laparoscopic (L) approaches Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) Roux-en-Y Gastric (RYGB) SO Super-Super Obese (SSO, 60 patients terms outcomes cost-effectiveness. Bariatric procedures performed from 2012 2023 were retrospectively reviewed. inclusion criteria , primary SADI-S or RYGB. Operative (OT), early complications, post-operative stay (POS), overall follow-up data analyzed. A subgroup analysis for surgical SSO was also performed. Among 4596 174 RYGB 91 selected. After Propensity Score Matching analysis, two groups identified (laparoscopic robot-assisted), each one composed 18 26 SADI-S. Intraoperative complication rates POS comparable. Mean OT longer compared laparoscopy (199.1 ± 65.7 109.5 39.1 min, respectively, p < 0.001). difference eliminated after only included (172.7 24.1 vs 152.6 26.2 min R-SADI-S L-SADI-S, = 0.107). surgeries associated higher (8134.6 1886.7 2386.7 388.2 € R-RYGB L-RYGB, respectively; 7996.6 873.1 3954.6 631.1 L-SADI-S). Despite costs, approach an added value more complex cases such as patients.