To evaluate the effectiveness and safety of robotic hand-sewn versus laparoscopic linear-stapled Roux-en-Y gastric bypass (RYGB) using propensity score matching in a clinical context.
Key Findings:
Robotic procedures had longer surgical durations (178 ± 25 min vs. 158 ± 22 min, p < 0.001).
Robotic interventions were more expensive (21,500 vs. 11,500 Saudi riyals, p < 0.001).
Length of stay was slightly reduced in the robotic cohort (1.8 ± 0.5 vs. 2.1 ± 0.5 days, p = 0.19).
Lower analgesia scores in the robotic group (2.1 ± 0.8 vs. 3.4 ± 1.1, p = 0.002) and reduced opioid consumption (32% vs. 69%, p = 0.01).
Complication rates and 12-month outcomes were similar between both groups.
Interpretation:
Robotic and laparoscopic RYGB show comparable effectiveness and safety, with robotic techniques offering reduced pain and opioid use but at the cost of longer operative times and higher expenses, which may influence clinical decision-making.
Limitations:
Retrospective design may introduce selection bias and limit causal inferences.
Small sample size limits generalizability of findings.
Single-center study may not reflect broader population outcomes.
Conclusion:
Robotic RYGB may be beneficial in select cases due to its pain management advantages, despite increased costs and operative time, suggesting a need for careful patient selection.
