Single-surgeon Transition From Laparoscopy to Robotic-assisted Bariatric and General Surgery: Throughput, Operative Times, and Learning-curve Trajectory Across 1664 Consecutive Cases.

BACKGROUND

The operational impact of transitioning from laparoscopic to robotic surgery is incompletely characterized, particularly regarding throughput and nonconsole operative time.

METHODS

We analyzed 1664 consecutive cases performed by a single surgeon (2023-2026), comparing laparoscopic (n=632) and robotic eras (n=1032). Throughput, operative time, and robotic OR overhead (skin-to-skin minus console time) were assessed using EMR, MBSAQIP, and vendor-derived data sources.

RESULTS

Weekly case volume increased from 9.54 to 11.36 (+19.1%), with stable OR days and increased cases per OR day (+17%). Robotic cases had longer operative times (SG +14.0 min; RYGB +27.6 min, P <0.001). The mean robotic OR overhead was ~19 minutes and consistent across independent data sources. Over time, overhead decreased by 30% (23.2 to 16.3 min; P <0.001), demonstrating improved efficiency.

CONCLUSIONS

Transition to robotic surgery increased throughput despite longer operative times. Robotic OR overhead is substantial but declines with experience, suggesting recoverable efficiency gains over time.