title: Comparison of the morbidity, weight loss, and relative costs between robotic and laparoscopic sleeve gastrectomy for the treatment of obesity in Brazil.
abstract: BACKGROUND
  In recent years, there has been renewed interest in using robotics in bariatric surgery for the treatment of morbid obesity. However, the high cost of a robotic surgical system has hindered its widespread use in developing countries. This study aims to compare the rate of morbidity, weight loss, and relative costs between laparoscopic (LSG) and robotic-assisted sleeve gastrectomy (RSG) performed for the treatment of obesity in a single center in Brazil.
  
  
  METHODS
  From January 2011 to March 2013, 48 severely obese patients underwent either LSG or RSG at our institution and were prospectively followed up for 12 months. Patients were free to choose either approach and were informed of any extra costs that may be incurred.
  
  
  RESULTS
  Thirty-two patients underwent LSG and 16 patients, RSG. No significant differences were observed between LSG and RSG groups regarding age, sex, BMI, incidence of comorbidities, duration of surgery, and length of hospital stay. Also, there were no significant between-group differences in BMI values evaluated at 6 and 12 months after surgery. Surgical costs were almost twice as high and total hospital costs were approximately 50 % higher in the robotic approach compared to the laparoscopic approach.
  
  
  CONCLUSIONS
  Both RSG and LSG had excellent and similar post-operative clinical outcomes. However, the much higher costs of purchasing and maintaining the robotic system are still precluding the use of RSG as a routine approach in the treatment of morbid obesity in Brazil.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Schraibman
authors.forename: Antonio L V
authors.initials: AL
authors.lastname: Macedo
authors.forename: Marina G
authors.initials: MG
authors.lastname: Epstein
authors.forename: Mayte Y
authors.initials: MY
authors.lastname: Soares
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maccapani
authors.forename: Delcio
authors.initials: D
authors.lastname: Matos
authors.forename: Luiz Vicente
authors.initials: LV
authors.lastname: Rizzo
authors.forename: Suzan M
authors.initials: SM
authors.lastname: Goldman
mesh_terms: D000328:Adult; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics; D016896:Treatment Outcome; D015431:Weight Loss