Robotic-assisted metabolic and bariatric surgery (MBS) is increasingly performed. The indications for and benefit of robotic-assisted sleeve gastrectomy (RSG) compared to conventional laparoscopy remains unclear. Little is known about perioperative outcomes among different racial cohorts undergoing RSG. The goal of our study was to evaluate outcomes following RSG between racial cohorts.
Using the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we identified primary RSG patients, after excluding revision, non-robotic cases and cases with missing data. Included cases were further stratified by race. A 1:1 case-control matching was performed of racial cohorts, comparing Black vs. White and Hispanic vs. White patients. 8,328 RSG cases were identified for the comparison between Whites vs. Blacks and Whites vs. Hispanics.
Between 2015 and 2017, RSG cases increased by 17%. Of 21,298 RSG cases analyzed, 62%, 21% and 11% were performed in White, Black and Hispanic patients, respectively. After matching (n = 8,164), outcomes between Black and White patients were similar, except for longer operative duration (p=0.02), length of stay (p < 0.0001), and a higher readmission rate in Black patients. Outcomes were similar between matched (n = 4852) White and Hispanics patients (Table 1).
While indications for RSG remain ill-defined, it is safely performed among racial metabolic and bariatric surgery cohorts. Despite undergoing RSG at disparate rates, primary and aggregate outcomes were mostly similar between racial cohorts. The reasons for higher operative time, length of stay and readmission in black patients need further exploration.