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Background

Numerous retrospective studies showed differences and noninferiority comparing laparoscopic sleeve gastrectomy (LSG) and robotic sleeve gastrectomy (RSG). This is a randomized control trial including teams specially trained in assisting with robotic surgery.

Methods

Between 06/2019 and 03/2021, demographic information was collected from 59 patients (8 (13.56%) male, 51 (86.44%) female patients) who underwent sleeve gastrectomy either laparoscopically (n=30) or robotically (n=29). Standardized surgery steps and pre-/postoperative multimodal pain control were used. Measurements included OR time, specimen size, complications, postoperative nausea, length of surgery, amount of weight loss, pain medication requirements.

Results

8 (13.56%) patients had complications post-operatively. Mean population age was 40.81±10.94, mean BMI was 43.80±8.40, mean length of stay was 38.20±13.98 hours, mean highest post-op pain score was 6.09±3.01, mean average post-op pain score was 4.21±2.37, mean specimen volume was 203.70±145.66cm2. 8 (13.56%) patients were reported to have complications post-operatively. Average BMI was significantly higher in robotic patients (46.00±9.80) vs. laparoscopic patients (41.67±6.23); p=0.05, average specimen volume in cubic centimeters was significantly higher in robotic patients (243.34±156.41) vs. laparoscopic patients (165.47±125.41); p=0.04. There was no significant difference in post op pain.

Conclusions

This is the first randomized double blinded prospective study comparing LSG and RSG, providing level 1 evidence supporting that RSG is a non-inferior technique to LSG. Although surgery duration was longer for RSG, length of hospital stay was not prolonged. Surgery duration can be mitigated with specially designated robotic teams.