Out by 3:30—A Study in Robotic Bariatric Surgery Efficiency

Abstract

Introduction: Little focus has been placed on improving the efficiency of robotic surgery. The aim of this study is to demonstrate areas of inefficiency between robotic (RSG) and laparoscopic sleeve gastrectomy (LSG) and show that the robot can be effectively integrated into a bariatric surgery practice. Methods: We retrospectively identified 25 consecutive LSG and RSG and compared preoperative (patient enters operating room (OR) to skin incision), operative (incision to skin closure), and postoperative (skin closure to out of OR) times. Analysis of variance comparing RSG versus LSG was performed, and turnover times for consecutive cases were analyzed. Results: The mean preoperative, operative, and postoperative times for LSG versus RSG are 42±8 versus 46±1, 88±19 versus 119±32, and 13±7.6 versus 11±5 minutes respectively. There is a statistically significant difference between LSG and RSG operative times (p<0.001), but there was no significance between preoperative (p=0.164) and postoperative (p=0.395) times. Conclusion: The primary contributor to longer duration of a robotic case is the operative time, not preoperative or postoperative times. RSG with a dedicated robotic team can be efficiently performed so that three consecutive RSG can be completed by 3:30 p.m. in a day.