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AbstractComparison of Robotic Surgery vs. Laparoscopic Surgery at a Single Center of Excellence : 90 day Perioperative Outcomes of Gastric SleeveBackground : Robotic Surgery is gaining popularity and availability. Comparative studies of Gastric Sleeve performed via Laparoscopic versus Robotic Platform at a Single Site Center of Excellence are lacking.Objective : To report our experience of Gastric Sleeve performed via Robotic or Laparoscopic SurgeryMethods : A retrospective review of Gastric Sleeve performed via Laparoscopic Surgery (N = 1626) and Robotic Surgery ( N = 1443) during 2016 to 2021 . All patients underwent surgery for Gastric Sleeve by one group. Data was collected by independent party following MBSAQIP database and Center of Excellence guidelines.ResultsWe reviewed LS & RS groups in % respectively: Length of Stay (1.5 ,1.2) Use of Blood Transfusions (0.1, 0.1) , Surgical Site Infections 04.0.1), 90 day readmissions (1.5,1.2), Staple Line Leak rate (0.3,0.1) , Venous thromboembolism DVT (0.2,0.2 ) Pulmonary Embolism (0.12,.07), Concomitant Hiatal Hernia Repair(37,47), BMI >45 (36,40), BMI >50 (15,20), Return to Operating Room (0.1,0.1), Stroke (0.1,0.0). LS group cost approximately $471.00 more than RS group. Conclusions Gastric Sleeve performed via Robotic Surgery offers comparable perioperative outcomes to Laparoscopic Surgery . While maintaining low negative outcomes , higher BMI patients and concomitant hiatal hernia patients were increased in the Robotic Surgery group. With comparable high volume, cost was lower in Robotic Group.