Highlights
- •RYGB in SO patients has similar SAE, OSI for robotic or laparoscopic approach
- •SG in SO patients has more SAE, OSI for robotic than laparoscopic approach
Abstract
Background
Bariatric surgery in the super-obese (SO) patient population represents a challenge.
Although the robotic platform is increasingly used for these patients, there are limited
data on outcomes compared with conventional laparoscopy.
Objective
Our study compared the safety and short-term outcomes of robotic and laparoscopic
platforms for SO patients compared with morbidly obese patients based on the 2015
to 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program
(MBSAQIP) database.
Setting
University Hospital, United States.
Methods
We evaluated all primary robotic and laparoscopic cases and extracted 30-day outcomes
in patients with body mass index <50 and ≤50 kg/m2. For our primary analysis, we used the Cochran-Mantel-Haenszel method with surgery
type Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) as the stratification
variable to determine the association between body mass index categories and outcomes.
Results
A total of 355,278 patients were included in our analysis. For the robotic RYGB (R-RYGB)
group (n = 6645) and R-SG (n = 15,984) there were 1674 SO patients (25.2%) and 3688
SO patients (23.1%), respectively.For the laparoscopic RYGB (LRYGB) group (n = 95,374)
and LSG group (n = 237,275), there were 24,991 (26.2%) and 51,524 SO patients (21.7%),
respectively. The incidence of serious adverse events in SO patients for R-RYGB and
LRYGB groups was 7.6% versus 7.2% (P > .05) and 4% versus 3.5% (P > .05) for R-SG and L-SG, respectively. The incidence of organ space infection in
SO patients for R-RYGB and LRYGB groups was .5% versus .4% (P > .05) and .4% versus .2% (P < .05) for R-SG and LSG, respectively.
Conclusions
Based on 2015 to 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement
Program data, we found no difference in outcomes between robotic and laparoscopic
approaches in SO patients. There was a higher incidence of serious adverse events
in SO patients compared with morbidly obese patients for both approaches.
Key words
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Article info
Publication history
Published online: October 19, 2019
Accepted:
October 10,
2019
Received:
March 27,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery.
