Long-Term Outcomes and Safety of Robotic Bariatric Surgery.

Abstract

Background: Bariatric surgery (BS) is the most effective treatment for sustained weight loss and improvement of obesity-related comorbidities. Robotic BS (RBS) offers enhanced precision and ergonomics; however, local data remain limited.

Methods: This retrospective real-world study included consecutive adults (≥18 years) who underwent single-surgeon robotic-assisted primary BS using the da Vinci® Surgical System (October 2012-December 2024), with complete perioperative and follow-up data.

Results: A total of 545 patients were analyzed with a mean age of 42.98 ± 11.15 years and a mean body mass index (BMI) of 44.55 ± 6.66 kg/m²). Sleeve gastrectomy (SG) was the most common procedure (72.48%), followed by Roux-en-Y gastric bypass (RYGB, 17.61%) and one-anastomosis gastric bypass (OAGB, 9.91%). Mean docking and operative times were 6.25 ± 2.29 and 99.84 ± 29.21 minutes, respectively. Intraoperative events were infrequent (console-related 2.57%, bedside-related 4.04%, instrument-related 3.12%), with no conversions. Mean intensive care unit (ICU) and hospital stays were 0.25 ± 0.45 and 2.42 ± 0.56 days. Thirty-day complications occurred in 2.02% of patients, comprising grade I (1.10%), grade II (0.73%), and grade III (0.18%) events. Between 1 month and 1 year, 1.28% experienced minor (grade I) complications. At 1 year, mean BMI decreased to 32.68 ± 4.02 kg/m², with no mortality. Outcomes in patients with BMI ≥ 50 kg/m² were comparable, supporting the safety and feasibility of RBS in grade IV obesity.

Conclusions: RBS proved safe, efficient, and effective, with low complications and consistent outcomes, supporting its use for obesity management in high-volume centers.