title: Robot-Assisted Versus Laparoscopic Sleeve Gastrectomy: Learning Curve, Perioperative, and Short-Term Outcomes.
abstract: Currently, sleeve gastrectomy is most commonly performed laparoscopically. However, robot-assisted approach for sleeve gastrectomy is increasing in number among bariatric surgeons. The aim of our study is to compare perioperative outcomes of robot-assisted (RA-LSG) and laparoscopic sleeve gastrectomy (LSG).
  
  
  
  Between June 2008 and December 2014, 647 patients underwent LSG and RA-LSG at our institution. A retrospective review was performed for 379 LSG and 268 R-LSG patients, noting the outcomes and complications of the procedure.
  
  
  
  The first 100 LSG and RA-LSG cases were separated to reflect the influence of learning curve. Mean length of hospital stay (LOS) was longer in RA-LSG patients at 1.3 ± 0.6 days (range, 1-4), while it was 1.1 ± 0.3 days (range, 1-2) in LSG patients. Thirty-day readmission rate was similar in both groups, 5.0 % in LSG and 6.0 % in RA-LSG group. One mortality (1.0 %) occurred in the RA-LSG group. In patients after 100 cases, mean LOS was still longer in RA-LSG patients at 1.7 ± 1.8 days (range, 1-21), while it was 1.2 ± 0.5 days (range, 1-5) LSG patients. Thirty-day readmission rate and 30-day reoperation rate did not show a significant difference between the two groups. Overall leak rate was 3.2 % (n = 9) in LSG group, and 1.9 % (n = 5) in RA-LSG group, and the difference was not statistically significant.
  
  
  
  Our study showed similar 30-day readmission and reoperation rate between LSG and RA-LSG during the learning curve and after the proficiency has been achieved.
authors.affiliation: Bariatric and Laparoscopy Center, Orando Regional Medical Center, Orlando, FL, USA.
authors.forename: Rena C
authors.initials: RC
authors.lastname: Moon
authors.affiliation: Bariatric and Laparoscopy Center, Orando Regional Medical Center, Orlando, FL, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Stephenson
authors.affiliation: Bariatric and Laparoscopy Center, Orando Regional Medical Center, Orlando, FL, USA.
authors.forename: Nelson A
authors.initials: NA
authors.lastname: Royall
authors.affiliation: Bariatric and Laparoscopy Center, Orando Regional Medical Center, Orlando, FL, USA.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Teixeira
authors.affiliation: Bariatric and Laparoscopy Center, Orando Regional Medical Center, Orlando, FL, USA. muhammad.jawad@orlandohealth.com.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Jawad
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010359:Patient Readmission; D059035:Perioperative Period; D012086:Reoperation; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Blood loss; Complication; Laparoscopic; Length of hospital stay; Perioperative outcomes; Robot-assisted; Sleeve gastrectomy