Robotic versus laparoscopic sleeve gastrectomy in adolescents: trends and short-term complications.

BACKGROUND

Robotic sleeve gastrectomy (SG) is increasingly used, but national comparative data in adolescents and young adults remain limited.

OBJECTIVES

To evaluate robotic SG trends and compare 30-day outcomes after robotic versus laparoscopic SG among patients aged 13 to 21 years.

SETTING

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, United States, 2015-2024.

METHODS

We performed a retrospective cohort study of patients aged 13 to 21 years undergoing minimally invasive SG. Outcomes included grouped complications, 30-day readmission, overall complications, and operative time. Multivariable regression adjusted for age, sex, body mass index, comorbidities, smoking, and year; propensity score matching and inverse probability weighting were sensitivity analyses.

RESULTS

Among 21,746 patients, 17,444 underwent laparoscopic SG and 4302 underwent robotic SG. Robotic utilization increased from 6.8% in 2015 to 34.3% in 2024. Robotic SG was not associated with higher adjusted odds of infectious complications (odds ratio, 1.04; 95% confidence interval, .65-1.62), pulmonary complications (1.34; .50-3.22), thromboembolic complications (1.85; .73-4.34), surgical complications (1.43; .91-2.18), readmission (1.01; .80-1.27), or overall complications (1.05; .85-1.29). Low event rates limited power for rare outcomes. Sensitivity analyses were concordant. Robotic SG had longer operative time by 21.2 min.

CONCLUSIONS

Robotic SG use increased nationally and was not associated with higher adjusted odds of complications, supporting short-term safety. Future studies should evaluate longer-term outcomes, cost, and access.