A Comprehensive Meta-Analysis of Laparoscopic Versus Robotic Roux-en-Y Gastric Bypass: Efficacy, Complications, and Outcomes

Background: The increasing prevalence of obesity, with associated health risks such as type 2 diabetes and cardiovascular disease, has led to the rise of bariatric surgery as a critical intervention. Roux-en-Y gastric bypass (RYGB) remains one of the most commonly performed bariatric procedures. The advent of robotic-assisted surgical techniques has raised questions regarding their comparative effectiveness and safety versus traditional laparoscopic approaches. Aim: This meta-analysis aims to systematically compare the clinical outcomes, complication rates, operative times, and overall effectiveness of laparoscopic versus robotic-assisted RYGB, expanding our understanding of their respective advantages and drawbacks. Methods: A thorough systematic review was conducted following PRISMA guidelines. A comprehensive search was performed across databases including PubMed, Cochrane Library, and Scopus up to October 2023. Selected studies were subjected to stringent inclusion and exclusion criteria. Statistical analysis employed both fixed-effects and random-effects models as appropriate. Results: A total of 30 studies, including randomized controlled trials (RCTs) and cohort studies, involving over 6,000 patients, were included. Robotic RYGB was associated with a significantly lower overall complication rate (OR 0.65; 95% CI 0.45–0.94; p = 0.02) but longer operative times (MD 30 minutes; 95% CI 20–40 minutes; p < 0.001) when compared to laparoscopic RYGB. Conclusions: Both laparoscopic and robotic methods are effective in achieving weight loss, but robotic RYGB may result in lower complication rates despite a longer operative time. The surgical approach should be tailored to individual patient needs and available resources.