# Robotic bariatric surgery in Australia: early outcomes from a national clinical quality registry with propensity score matched analysis

## TL;DR

This study compares robotic and laparoscopic bariatric surgery outcomes in Australia, finding similar results after adjusting for factors.

## Contribution

The study provides early national data on robotic bariatric surgery outcomes using a large registry and propensity score matching.

## Key findings

- Robotic MBS was associated with more gastric/duodenal-ileal bypasses and revisional procedures compared to laparoscopic MBS.
- Adjusted analysis showed comparable clinical outcomes and no increased risks for robotic MBS.
- Direct comparison revealed more adverse events in the robotic MBS group before adjustment.

## Abstract

The robotic approach to metabolic bariatric surgery (MBS) is becoming more popular despite limited data supporting beneficial outcomes. The objective of this study was to evaluate the early outcomes of robotic MBS in Australia. An observational analysis of prospectively maintained data from the Australian arm of the Australia and New Zealand Bariatric Surgery Registry between 2014 to June 2022 were conducted. All patients who underwent robotic MBS (RMBS) were propensity score matched 1:1 to laparoscopic MBS (LMBS) within the Registry. Clinical outcomes were compared using conditional logistic regression analyses. A total of 66,232 patients were included (LMBS n = 65,322; RMBS n = 910) in the analysis. The majority of RMBS were gastric or duodenal-ileal bypasses, significantly higher than the LMBS cohort (49.6 vs 24.3%, p < 0.0001) and more were revisional procedures (26% vs 19.6%, p < 0.0001). On direct comparison, there were significantly more defined adverse events in the RMBS group. When adjusted for cofounders, clinical outcomes of RMBS were comparable to LMBS with no increased risks of defined adverse events or complications.

The online version contains supplementary material available at 10.1007/s11701-025-02355-9.