Sleeve Gastrectomy (SG) is the most common bariatric procedure worldwide. As a minimally invasive procedure, SG is performed both laparoscopic and robotic-assisted techniques.A Potential advantage of the robotic-assisted is reduced postoperative pain. Studies evaluating pain assessment in robotic SG are limited and comparison between laparoscopic SG has not been reported. Evidence about pain management and its effects on pain scores in SG remains unknown. The aim of this study was to evaluate the pain scores after robotic SG compared to laparoscopic SG and to determine its correlation with the pain management.


This retrospective study was conducted between September 2015 and November 2020. Patients undergoing robotic and laparoscopic SG were included (Table 1). Pain scores (Numeric Rating Scale) and pain medication use data were collected from immediate postoperative to 48-hours after surgery. Linear-mixed-effects model were used to compared pain ratings across laparoscopic and robotic groups after accounting for time and pain management.


Results: 484 patients were included, 49 robotic SG and 435 laparoscopic SG. Patients in the robotic SG rated their pain ~0.43 points lower than laparoscopic SG (p = .035). The magnitude of this group difference is moderate (~0.5 standard deviation). During the first 48-hours postoperative, parallel time-trends were found across groups: pain scores do not significantly differ from immediate postoperative through 8-hours postoperative, then significantly drop and remain constant during 12-48 hours, favoring robotic SG (Figure 1).


Our results suggested that robotic SG resulted in lower pain scores compared to laparoscopic SG after 12-hours postoperative.