Robotic-assisted techniques are increasingly used in bariatric surgery. We investigated the safety and operative outcomes of robotic and laparoscopic bariatric surgery.


We used the MBSAQIP national registry from 2015-2019 to identify patients who underwent SG (CPT 43775) or RYGB (CPT 43644) with a robotic or laparoscopic technique. Analyses excluded patients with emergent surgery, revisional surgery, ASA class 5, and those with conditions present at the time of surgery.


A total of 685,932 and 68,465 patients underwent laparoscopic and robotic bariatric surgery, respectively. The robotic approach had significantly longer operative time by 25 and 33 minutes for SG and RYGB, respectively, with no difference in days to discharge or 30-day mortality. Within SG, the robotic approach had statistically significant higher incidences of ED visits (6.7% vs. 6.1%), re-admissions (3.3% vs. 2.9%), and interventions at 30-days (1.0% vs. 0.8%). Within RYGB, the robotic approach had statistically significant higher rates of re-admission (6.9% vs. 5.7%) and re-operation (2.5% vs. 2.2%), however the laparoscopic approach demonstrated higher rates of serious adverse events (2.8% vs. 3.2%) driven by higher rates of blood transfusion (0.7% vs. 1.1%).


While the robotic approach involves longer operative times, it does not affect length of stay or 30-day mortality. There are slightly higher rates of ED visits for robotic SG, higher rates of re-admissions for robotic SG and RYGB, and slightly higher rates of blood transfusion for laparoscopic RYGB. Overall, both techniques are safe with very low complication rates at 30-days.