Surgery · 2026
National trends and outcomes of robotic and laparoscopic bariatric surgery in the United States.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tran Darren, Ali Konmal, Wong Jayden, Bossolina Stephanie, Lai Owen, Chen Yijun, Benharash Peyman
Аннотация
BACKGROUND: While robotic-assisted metabolic and bariatric surgery has experienced rapid national adoption, data on postoperative outcomes relative to laparoscopic approaches remain mixed. The present study used a nationally representative cohort to characterize outcomes and resource utilization across laparoscopic and robotic metabolic and bariatric surgery.
METHODS: All elective adult (≥18 years) hospitalizations for primary robotic or laparoscopic metabolic and bariatric surgery were extracted from the 2016-2022 National Readmissions Database. Eligible procedures included adjustable gastric banding, biliopancreatic diversion/duodenal switch, Roux-en-Y gastric bypass, and sleeve gastrectomy. Multivariable models were developed to assess the association of procedure approach with outcomes of interest. Restricted cubic spline analysis examined the volume-cost relationship at the hospital level.
RESULTS: Of an estimated 1,136,027 patients, 938,999 (82.6%) comprised the laparoscopic cohort. Compared with robotic metabolic and bariatric surgery, the laparoscopic cohort was less commonly female and demonstrated lower Elixhauser Comorbidity Indices. Following risk adjustment, laparoscopic intervention was associated with reduced odds of major adverse events (adjusted odds ratio, 0.58; 95% confidence interval, 0.46-0.75), infectious complications (adjusted odds ratio, 0.28; 95% confidence interval, 0.18-0.42), and respiratory complications (adjusted odds ratio, 0.81; 95% confidence interval, 0.71-0.92). The laparoscopic approach was additionally associated with lower costs (β = -4.1; 95% confidence interval, -4.6 to -3.7) and reduced odds of 30-day readmission (adjusted odds ratio, 0.85; 95% confidence interval, 0.81-0.90), compared with robotic.
CONCLUSION: In this nationally representative analysis, robotic metabolic and bariatric surgery was not associated with a short-term clinical advantage over laparoscopic approaches, despite higher resource utilization. These findings underscore the need for rigorous prospective evaluation of the clinical and economic value of robotic metabolic and bariatric surgery prior to its continued expansion.
METHODS: All elective adult (≥18 years) hospitalizations for primary robotic or laparoscopic metabolic and bariatric surgery were extracted from the 2016-2022 National Readmissions Database. Eligible procedures included adjustable gastric banding, biliopancreatic diversion/duodenal switch, Roux-en-Y gastric bypass, and sleeve gastrectomy. Multivariable models were developed to assess the association of procedure approach with outcomes of interest. Restricted cubic spline analysis examined the volume-cost relationship at the hospital level.
RESULTS: Of an estimated 1,136,027 patients, 938,999 (82.6%) comprised the laparoscopic cohort. Compared with robotic metabolic and bariatric surgery, the laparoscopic cohort was less commonly female and demonstrated lower Elixhauser Comorbidity Indices. Following risk adjustment, laparoscopic intervention was associated with reduced odds of major adverse events (adjusted odds ratio, 0.58; 95% confidence interval, 0.46-0.75), infectious complications (adjusted odds ratio, 0.28; 95% confidence interval, 0.18-0.42), and respiratory complications (adjusted odds ratio, 0.81; 95% confidence interval, 0.71-0.92). The laparoscopic approach was additionally associated with lower costs (β = -4.1; 95% confidence interval, -4.6 to -3.7) and reduced odds of 30-day readmission (adjusted odds ratio, 0.85; 95% confidence interval, 0.81-0.90), compared with robotic.
CONCLUSION: In this nationally representative analysis, robotic metabolic and bariatric surgery was not associated with a short-term clinical advantage over laparoscopic approaches, despite higher resource utilization. These findings underscore the need for rigorous prospective evaluation of the clinical and economic value of robotic metabolic and bariatric surgery prior to its continued expansion.