The rate of both revisional and robotic bariatric surgery is increasing. The advantages of robotic surgery in this setting are not clearly defined. Compare patient characteristics and outcomes of laparoscopic and robotic revisional bariatric surgery
Out of 138 revisions, 87 were robotic(63%) and 51-laparoscopic(37%).The groups did not differ significantly in age(46y), sex(85% female),BMI (43.2).Robotic surgery was used more frequently for more complex procedures(Figure 1).The robotic group had more patients with history of another revision–19.5% vs 5.8%.Robotic revisional operations took longer-268 min, compared to 142 min for laparoscopy.In spite of the higher complexity of cases,outcomes were not statistically different between groups(Table 1)-equivalent LOS(2days) and rate of readmission(4%).Complication rate was higher in the robotic group, but the difference was not statistically significant-major complications(5.7% vs 1.9%).There were 4 leaks in the robotic group and none in the laparoscopic group (4.5% vs 0%, p=0.045).The EWL at 1 year was lower in the robotic group(52.5% vs 67.3%). This is explained by the higher number of patients in the robotic group with history of gastric bypass, which in our series, have lower weight loss compared to band and sleeve revisions.
Robotic revisional bariatric surgery has a similar safety profile to laparoscopy, even when used selectively for more complex operations.