Robot-Assisted Versus Laparoscopic Sleeve Gastrectomy: Learning Curve, Perioperative, and Short-Term Outcomes.

Abstract

Currently, sleeve gastrectomy is most commonly performed laparoscopically. However, robot-assisted approach for sleeve gastrectomy is increasing in number among bariatric surgeons. The aim of our study is to compare perioperative outcomes of robot-assisted (RA-LSG) and laparoscopic sleeve gastrectomy (LSG). Between June 2008 and December 2014, 647 patients underwent LSG and RA-LSG at our institution. A retrospective review was performed for 379 LSG and 268 R-LSG patients, noting the outcomes and complications of the procedure. The first 100 LSG and RA-LSG cases were separated to reflect the influence of learning curve. Mean length of hospital stay (LOS) was longer in RA-LSG patients at 1.3 ± 0.6days (range, 1-4), while it was 1.1 ± 0.3days (range, 1-2) in LSG patients. Thirty-day readmission rate was similar in both groups, 5.0% in LSG and 6.0% in RA-LSG group. One mortality (1.0%) occurred in the RA-LSG group. In patients after 100 cases, mean LOS was still longer in RA-LSG patients at 1.7 ± 1.8days (range, 1-21), while it was 1.2 ± 0.5days (range, 1-5) LSG patients. Thirty-day readmission rate and 30-day reoperation rate did not show a significant difference between the two groups. Overall leak rate was 3.2% (n = 9) in LSG group, and 1.9% (n = 5) in RA-LSG group, and the difference was not statistically significant. Our study showed similar 30-day readmission and reoperation rate between LSG and RA-LSG during the learning curve and after the proficiency has been achieved.