Robot-Assisted Sleeve Gastrectomy for Super-Morbidly Obese Patients

Background: Sleeve gastrectomy represents a valid option for morbidly obese patients, either as a primary or as a staged bariatric procedure. Several variations of the technique have been reported. Herein, we report our initial experience with robot-assisted sleeve gastrectomy (RASG). Materials and Methods: A prospectively held database for patients who underwent RASG was reviewed. Data included patient demographics, operative parameters, morbidity, and follow-up outcomes. The outcomes after RASG were compared to the laparoscopic approach. Results: From September 2007 to February 2010, 69 morbidly obese patients underwent sleeve gastrectomy. Of these, 30 (43.5%) were robot-assisted and 39 (56.5%) were laparoscopic. There was no statistically significant difference in demographics between the two groups. The RASG group underwent an oversewing of the staple line, and mean operative time was 135 minutes. In the laparoscopic group, where the staple line was not oversewn, mean operative time was 114 minutes (P = .003). Morbidity after RASG was 3.3%, and there were no gastrointestinal leaks or staple line bleeding. Mean postoperative hospital stay after RASG was 2.6 days (range: 1.6–8.3 days). Mean body mass index decrease at 1 year was 16 kg/m2. There were no differences between the two groups in terms of morbidity, mortality, length of stay, and weight loss. Conclusions: RASG can be performed safely, with good outcomes. However, the exact role and the advantages of RASG require further study in larger series.