Abstracts DGAV

Background:Robotic surgery is increasingly being used for various indications in visceral surgery.The utilization of robotic assistance systems is also increasing significantly in metabolic surgery.In our tertiary care center with an established robotic program in surgical oncology and a competence center for bariatric surgery, we commenced a program with robot-assisted bariatric surgery in January 2021. Materials and methods:We performed a retrospective analysis of robotic procedures in metabolic surgery in our centre beginning in 2021 until 2023.Analyzed parameters were: ratio of laparoscopic vs robotic procedures, operative time, length of hospital stay, complication rates and type of procedure. Results:Of a total of 111 procedures, 27 were performed robotically in 2021.This ratio was kept similar in the following years (40 of 123 in 2022, 28 of 139 of 2023).Initially, there was no selection of patients.Length of stay and, in particular, complication rates did not show any significant difference.Duration of operation (including docking times) in average was 20 minutes longer in comparison between robotic and laparoscopic procedures.This OR time difference remained, however, we performed a higher percentage of complex procedures with the robot in the later years.In the subgroup of more complex bariatric procedure (roux-en-y gastric bypass) we could show a reduction in OR time in the following years from 123 min to 105 min in average while laparoscopic times kept stable around 92 to 99 minutes. Conclusion:In the appropriate setting and with existing expertise, robotic bariatric surgery can be safely established within 12 months and the learning curve can largely be overcome after around 30-50 cases.OR time reduction can be seen in the subgroup of more complex cases over a period of three years, indicating a potentially longer learning curve in these procedures.OR times in robotic bariatric surgery are slightly longer than in the laparoscopic setting.