title: Robotic sleeve gastrectomy: experience of 134 cases and comparison with a systematic review of the laparoscopic approach.
abstract: BACKGROUND
  Robotic technology has recently emerged in different surgical specialties, but the experience with robotic sleeve gastrectomy (RSG) is scarce in the literature. The purpose of this study is to compare our preliminary experience with RSG versus the descriptive results of a systematic review of the laparoscopic approach.
  
  
  METHODS
  Data from our RSG experience were retrospectively collected. Two surgeons performed all the cases in one single surgery center. Such information was compared with a systematic review of 22 selected studies that included 3,148 laparoscopic sleeve gastrectomy (LSG) cases. RSG were performed using the daVinci Surgical System.
  
  
  RESULTS
  This study included 134 RSG vs. 3,148 LSG. Mean age and mean BMI was 43 ± 12.6 vs. 40.7 ± 11.6 (p = 0.022), and 45 ± 7.1 vs. 43.6 ± 8.1 (p = 0.043), respectively. Leaks were found in 0 RSG vs. 1.97% LSG (p = 0.101); strictures in 0 vs. 0.43% (p = 0.447); bleeding in 0.7 vs. 1.21% (p = 0.594); and mortality in 0 vs. 0.1% (p = 0.714), respectively. Mean surgical time was calculated in 106.6 ± 48.8 vs. 94.5 ± 39.9 min (p = 0.006); and mean hospital length of stay was 2.2 ± 0.6 vs. 3.3 ± 1.7 days (p = <0.005), respectively. Four (2.9%) complications were found in our robotic series.
  
  
  CONCLUSIONS
  Our series shows that RSG is a safe alternative when used in bariatric surgery, showing similar results as the laparoscopic approach. Surgical time is longer in the robotic approach, while hospital length of stay is lower. No leaks or strictures were found in the robotic cases. However, further studies with larger sample size and randomization are warranted.
authors.affiliation: Department of General and Bariatric Surgery, South Miami Hospital, Baptist Health South Florida, 7800 SW 87th Avenue Suite B210, Miami, FL, 33173, USA, reyr@baptisthealth.net.
authors.forename: Rey Jesús
authors.initials: RJ
authors.lastname: Romero
authors.forename: Radomir
authors.initials: R
authors.lastname: Kosanovic
authors.forename: Jorge Rafael
authors.initials: JR
authors.lastname: Rabaza
authors.forename: Rupa
authors.initials: R
authors.lastname: Seetharamaiah
authors.forename: Charan
authors.initials: C
authors.lastname: Donkor
authors.forename: Michelle
authors.initials: M
authors.lastname: Gallas
authors.forename: Anthony Michael
authors.initials: AM
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D025321:Surgery, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
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