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Background <p>Sleeve gastrectomy (SG) is the most common bariatric procedure worldwide. While robotic sleeve gastrectomy (RSG) offers potential technical advantages over the laparoscopic approach (LSG), concerns remain regarding its impact on surgical outcomes and temporal trends. This study aimed to compare the frequency and risk of postoperative outcomes between RSG and LSG.</p> Methods <p>A retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was conducted, including patients from 2015 to 2023 who underwent primary SG without concomitant procedures. The primary outcome was overall postoperative complications (OPC). Secondary outcomes included staple line complications (SLC: gastrointestinal bleeding and leaks) and unplanned healthcare utilization (UHCU). Temporal trends were analyzed through linear correlation analysis (<i>R</i><sup>2</sup>). Multivariable logistic regression analysis and stratified analysis were used to assess for bias.</p> Results <p>A total of 567,199 patients were included, of whom 81.3% (<i>n</i> = 461,343) underwent LSG and 18.7% (<i>n</i> = 105,856) underwent RSG. Most patients were female (79.7%, <i>n</i> = 452,009) with a mean age of 42.4 ± 11.8&#xa0;years and a mean BMI of 45.3 ± 7.9&#xa0;kg/m<sup>2</sup>. Patients undergoing RSG had a higher frequency of OPC (1.93 vs. 1.57%, <i>p</i> &lt; 0.001), SLC (0.66 vs. 0.64%, <i>p</i> = 0.838), and UHCU (9.4 vs. 8.6%, <i>p</i> &lt; 0.001), with no difference in mortality. The robotic approach was independently associated with increased odds of OPC (adjusted OR 1.21; 95% CI 1.153–1.274). An increasing trend in OPC was observed throughout the study period, with a more pronounced increase in the RSG group (<i>R</i><sup>2</sup> = 0.5088) compared with the LSG group (<i>R</i><sup>2</sup> = 0.2107).</p> Conclusions <p>Robotic sleeve gastrectomy was associated with a higher frequency of OPC and UHCU, although the absolute risk increase was small. No significant differences were observed in SLC. Additionally, an increasing trend in OPC was noted in recent years, which was more pronounced in the RSG group.</p> Graphical abstract <p></p>

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Rise of robotic sleeve gastrectomy fails to show improved outcomes versus laparoscopy analysis of 9 years of MBSAQIP data including over half a million patients

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Yeisson Rivero-Moreno,
  • Juan Zubillaga-Gutierrez,
  • Omar Bellorin

摘要

Background

Sleeve gastrectomy (SG) is the most common bariatric procedure worldwide. While robotic sleeve gastrectomy (RSG) offers potential technical advantages over the laparoscopic approach (LSG), concerns remain regarding its impact on surgical outcomes and temporal trends. This study aimed to compare the frequency and risk of postoperative outcomes between RSG and LSG.

Methods

A retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was conducted, including patients from 2015 to 2023 who underwent primary SG without concomitant procedures. The primary outcome was overall postoperative complications (OPC). Secondary outcomes included staple line complications (SLC: gastrointestinal bleeding and leaks) and unplanned healthcare utilization (UHCU). Temporal trends were analyzed through linear correlation analysis (R2). Multivariable logistic regression analysis and stratified analysis were used to assess for bias.

Results

A total of 567,199 patients were included, of whom 81.3% (n = 461,343) underwent LSG and 18.7% (n = 105,856) underwent RSG. Most patients were female (79.7%, n = 452,009) with a mean age of 42.4 ± 11.8 years and a mean BMI of 45.3 ± 7.9 kg/m2. Patients undergoing RSG had a higher frequency of OPC (1.93 vs. 1.57%, p < 0.001), SLC (0.66 vs. 0.64%, p = 0.838), and UHCU (9.4 vs. 8.6%, p < 0.001), with no difference in mortality. The robotic approach was independently associated with increased odds of OPC (adjusted OR 1.21; 95% CI 1.153–1.274). An increasing trend in OPC was observed throughout the study period, with a more pronounced increase in the RSG group (R2 = 0.5088) compared with the LSG group (R2 = 0.2107).

Conclusions

Robotic sleeve gastrectomy was associated with a higher frequency of OPC and UHCU, although the absolute risk increase was small. No significant differences were observed in SLC. Additionally, an increasing trend in OPC was noted in recent years, which was more pronounced in the RSG group.

Graphical abstract