Revisional Metabolic and Bariatric Surgery (R-MBS) is increasing performed in the USA. Between 2011 and 2017, rates increased from 6% to14%. The robotic platform in also increasingly used. Little is known about perioperative outcomes in racial cohorts undergoing R-MBS. Our study goal was to evaluate outcomes following robotic R-MBS between racial cohorts.
From the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we identified patients having a robotic-assisted R-MBS using the revision/conversion and surgical approach variables in the database. Included cases were further stratified by race. 1:1 case-control matching was performed of racial cohorts, comparing Black vs. White and Hispanic vs. White patients. Cohorts were matched by patient demographics and preoperative comorbidities.
Of 2027 robotic-assisted R-MBS cases analyzed, 63%, 21%, 9% were performed in White, Black and Hispanic patients, respectively. After matched analysis (n = 850), outcomes between Black and White patients were similar, except for higher rates of organ space SSI (p = 0.045) and aggregate leak (p = 0.056) in Black patients. Outcomes were similar between matched (n = 392) White and Hispanics patients, except for a higher rate of aggregate bleeding (p = 0.044) in Whites. Overall and bariatric related morbidity were similar between racial cohorts (Table 1).
Robotic-assisted revisional metabolic and bariatric surgery is overall safe in racial cohorts, with little difference in perioperative outcomes. Further research is needed to understand reasons for higher rates of aggregate leak in Black patients and aggregate bleeding in White patients.