Proceedings (Baylor University. Medical Center) · 2025
Association of robotic vs laparoscopic technique on postoperative opioid consumption among patients who underwent bariatric surgery: a single-center cohort study.
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Fair Lucas C, Kruger Jessica, Waddimba Anthony C, Baker Bailey M, Ogola Gerald O, Davis Daniel G
Аннотация
BACKGROUND: Robotic platforms are increasingly utilized in bariatric surgery to overcome technical limitations of traditional laparoscopy. However, the impact of robotics on postoperative pain control is not fully understood. This study aimed to compare pain control outcomes following primary bariatric surgery performed via robot-assisted approaches versus conventional laparoscopy.
METHODS: This retrospective investigation involved all adults who underwent primary bariatric surgeries at a single institution from August 2016 to January 2019. Multivariable generalized linear and ordinal logistic regression models were fitted to test predictive associations of the robotic vs laparoscopic surgical technique with postoperative in-hospital opioid consumption and pain intensity ratings, independent of covarying risk factors.
RESULTS: A total of 340 patients (201 in the robotic group and 139 in the laparoscopic group) were included in the study. Baseline preoperative characteristics were similar between comparison groups, except mean body mass index was significantly higher among robotic surgery recipients (47.7 vs 44.0 kg/m2; P < 0.001). Postoperative in-hospital opioid consumption did not significantly differ among recipients of robotic versus laparoscopic bariatric surgery. No difference was detected between comparison cohorts in total inpatient opioid use (P = 0.30), opioid use in the postanesthesia care unit (P = 0.98), or average opioid use per inpatient day (P = 0.18). Similarly, in multivariable ordinal logistic regression models of postoperative day 0 and postoperative day 1 pain ratings, perceived pain intensity was not significantly higher following robotic versus laparoscopic primary bariatric surgeries, after accounting for other risk factors.
CONCLUSION: Compared to conventional laparoscopy, robotic primary bariatric procedures did not independently decrease postoperative in-hospital opioid utilization or pain intensity.
METHODS: This retrospective investigation involved all adults who underwent primary bariatric surgeries at a single institution from August 2016 to January 2019. Multivariable generalized linear and ordinal logistic regression models were fitted to test predictive associations of the robotic vs laparoscopic surgical technique with postoperative in-hospital opioid consumption and pain intensity ratings, independent of covarying risk factors.
RESULTS: A total of 340 patients (201 in the robotic group and 139 in the laparoscopic group) were included in the study. Baseline preoperative characteristics were similar between comparison groups, except mean body mass index was significantly higher among robotic surgery recipients (47.7 vs 44.0 kg/m2; P < 0.001). Postoperative in-hospital opioid consumption did not significantly differ among recipients of robotic versus laparoscopic bariatric surgery. No difference was detected between comparison cohorts in total inpatient opioid use (P = 0.30), opioid use in the postanesthesia care unit (P = 0.98), or average opioid use per inpatient day (P = 0.18). Similarly, in multivariable ordinal logistic regression models of postoperative day 0 and postoperative day 1 pain ratings, perceived pain intensity was not significantly higher following robotic versus laparoscopic primary bariatric surgeries, after accounting for other risk factors.
CONCLUSION: Compared to conventional laparoscopy, robotic primary bariatric procedures did not independently decrease postoperative in-hospital opioid utilization or pain intensity.