Robotic vs. Laparoscopic Roux-en-Y Gastric Bypass: Insights from the MBSAQIP Database

A Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (2020–2023) registry analysis shows equivalent 30-day complication rates for robotic and laparoscopic Roux-en-Y in patients with BMI ≥ 60 kg/m2. This retrospective cohort study used multivariable adjustment to account for baseline differences and reports that the BMI ≥ 60 subgroup was sufficiently powered for the subgroup comparisons.

The registry includes more than 230,000 Roux-en-Y cases from 2020–2023, providing robust sample size for subgroup assessment.

Laparoscopic Roux-en-Y remains the conventional standard, but robotic platforms have seen wider adoption for technically complex and high-risk anatomy. Patients with BMI ≥ 60 kg/m2 form a distinct, higher-risk cohort due to altered physiology and operative complexity.

That safety equivalence contrasts with differences in operative efficiency and resource use. The MBSAQIP report notes longer median operative times for robotic cases alongside shorter median inpatient stays for the robotic cohort, producing a tangible tradeoff between OR time and inpatient capacity.