Robotic versus Laparoscopic Sleeve-to-Gastric Bypass Conversion: A Comparison of Short- and Long-Term Outcomes.

Background: With the rise in bariatric surgeries, conversions for issues like poor weight loss or reflux are becoming more common. Gastric bypass is a standard solution, but as robotic use grows, its advantage over laparoscopy remains in question. Objective: Compare the short and long-term outcomes of robotic versus laparoscopic sleeve conversion to Roux-en-Y gastric bypass (RYGB) surgeries. Methods: We conducted a retrospective analysis analyzing patients' demographics, comorbidities, reasons for conversion, preoperative body mass index (BMI), and perioperative metrics (operative time, blood loss, hospital stay). We compared surgical outcomes, including early complications, rehospitalization, reintervention, weight loss, and resolution of comorbidities, between the robotic and laparoscopic approaches. Results: This cohort included 126 patients who underwent revisional surgery from sleeve gastrectomy to gastric bypass surgery. Out of which 27 underwent laparoscopic approaches and 99 robotic approaches. The mean age of patients was 52.5 (±11.6), and the mean pre-RYGB BMI was 36.1 (±7.1). Most patients were female (87.3%, n = 110), with 72.2% white. Robotic approach had a significantly shorter operative time than laparoscopic approach 184.1 vs 215.5 minutes, with P-value < .001, respectively. Other outcomes did not show any statistical significance between the two groups. However, the late reoperation rate revealed a significant difference, with 29.6% in the laparoscopic group required additional surgical intervention, whereas only 13.1% in the robotic group with P-value .041, suggesting advantage for the robotic approach. Conclusion: Both techniques demonstrated similar complication rates. Notably, the robotic approach resulted in shorter operating times and fewer late reoperations. Further research is necessary to strengthen our findings.