Single-surgeon Transition From Laparoscopy to Robotic-assisted Bariatric and General Surgery: Throughput, Operative Times, and Learning-curve Trajectory Across 1664 Consecutive Cases

Background: The operational impact of transitioning from laparoscopic to robotic surgery is incompletely characterized, particularly regarding throughput and nonconsole operative time. Methods: We analyzed 1664 consecutive cases performed by a single surgeon (2023-2026), comparing laparoscopic (n=632) and robotic eras (n=1032). Throughput, operative time, and robotic OR overhead (skin-to-skin minus console time) were assessed using EMR, MBSAQIP, and vendor-derived data sources. Results: Weekly case volume increased from 9.54 to 11.36 (+19.1%), with stable OR days and increased cases per OR day (+17%). Robotic cases had longer operative times (SG +14.0 min; RYGB +27.6 min, P <0.001). The mean robotic OR overhead was ~19 minutes and consistent across independent data sources. Over time, overhead decreased by 30% (23.2 to 16.3 min; P <0.001), demonstrating improved efficiency. Conclusions: Transition to robotic surgery increased throughput despite longer operative times. Robotic OR overhead is substantial but declines with experience, suggesting recoverable efficiency gains over time.