Comparative Analysis of Robotic Hand-Sewn and Laparoscopic RYGB

Overview

This study compares robotic hand-sewn versus laparoscopic linear-stapled Roux-en-Y gastric bypass (RYGB) using propensity score matching. Findings indicate that while robotic procedures have longer operative times and higher costs, they result in lower pain and opioid consumption.

Background

Roux-en-Y gastric bypass is a key surgical option for obesity management and can be performed as a primary intervention or as a conversion from sleeve gastrectomy. With rising obesity rates and associated comorbidities, understanding the comparative effectiveness and safety of surgical techniques is crucial for optimizing patient outcomes. This study addresses the gap in data comparing robotic and laparoscopic techniques in RYGB procedures.

Data Highlights

Key Findings

• Robotic RYGB had a longer operative duration compared to laparoscopic RYGB (178 vs. 158 min).
• Robotic procedures incurred higher costs (21,500 vs. 11,500 Saudi riyals).
• Postoperative analgesia scores were significantly lower in the robotic cohort (2.1 vs. 3.4).
• Opioid consumption was reduced in the robotic group (32% vs. 69%).
• Length of stay was marginally shorter in the robotic group (1.8 vs. 2.1 days).
• Complication rates and 12-month outcomes were similar between both techniques.

Clinical Implications

Surgeons should consider the benefits of robotic RYGB, particularly in reducing postoperative pain and opioid use, despite the higher costs and longer operative times. The findings support the selective use of robotic techniques in complex cases where precision is paramount.

Conclusion

Robotic and laparoscopic RYGB techniques demonstrate comparable safety and effectiveness, with the robotic approach offering advantages in pain management. Further studies are warranted to evaluate long-term outcomes and cost-effectiveness.

Related Resources & Content

1. Obesity Surgery, 2018 -- Are Outcomes Improved with Robotic Roux-en-Y Gastric Bypass Compared to Traditional Laparoscopic Techniques?
2. Obesity Surgery, 2020 -- Comparative Safety of Single-Stage Revision Laparoscopic Sleeve Gastrectomy versus Laparoscopic Roux-en-Y Gastric Bypass Following Failed Gastric Banding
3. Updates in Surgery, 2025 -- Comparative Analysis of Totally Robotic Sleeve Gastrectomy and Laparoscopic Sleeve Gastrectomy During the Learning Phase: Investigating Variations in Operative Duration
4. Obesity Surgery, 2023 -- Outcomes of Revision Laparoscopic Sleeve Gastrectomy Following Gastric Banding: A Study Utilizing Propensity Score Matching
5. PubMed, 2024 -- Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials
6. PubMed, 2025 -- Global trends and outcomes in robotic vs. laparoscopic Roux-en-Y gastric bypass: a 25-year meta-analysis of 38,647 patients across 27 countries
7. ​​Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials - PubMed
8. Global trends and outcomes in robotic vs. laparoscopic Roux-en-Y gastric bypass: a 25-year meta-analysis of 38,647 patients across 27 countries - PubMed
9. Linear-Stapled Gastrojejunal Anastomosis Linked to Higher Marginal Ulcer Rates After Roux-en-Y Gastric Bypass: A Cohort of 1875 Patients - Yeisson Rivero-Moreno, Arturo Estrada, Valentina Viscarret, Adnan Khoja, Grishma Patel, Yashraj Srivastava, Victoria Dai, Shannon Keisling, Jenny Choi, Erin Moran-Atkin, Diego Camacho, 2026