Clinical efficacy of Da Vinci robotic sleeve gastrectomy in the treatment of obesity

Objective To investigate the clinical efficacy of Da Vinci robotic sleeve gastrec-tomy in the treatment of obesity.

Methods The retrospective and descriptive study was conducted. The clinical data of 253 patients with obesity who underwent Da Vinci robotic sleeve gastrectomy at People′s Hospital of Xinjiang Uygur Autonomous Region between April 2021 and March 2025 were collected. There were 81 males and 172 females, aged 34 (range, 15-63) years. The body mass index (BMI) of patients was 40.08 (range, 26.79-66.61) kg/m². Observation indicators: (1) surgical and postoperative situations; (2) correlation analysis between BMI and perioperative indicators; (3) analysis of influencing factors for operation time. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers. Spearman rank correlation analysis was used for correlation assessment. Univariate and multivariate analyses were performed using the linear regression model.

Results (1) Surgical and postoperative situations: all 253 patients successfully underwent Da Vinci robotic sleeve gastrectomy without conversion to laparoscopic or open surgery. Of 253 patients, 95 cases underwent concomitant hiatal hernia repair, 40 cases underwent conco-mitant gastric fundoplication, 36 cases underwent concomitant His angle reconstruction, 28 cases underwent concomitant cholecystectomy, 8 cases underwent concomitant abdominal wall or inci-sional hernia repair, and 1 case underwent concomitant diaphragmatic hernia repair. Some patients underwent multiple concomitant procedures simultaneously. The operation time was 121 (range, 83-390) minutes, volume of intraoperative blood loss was 20 (range, 5-200) mL, duration of post-operative hospital stay was 4 (range, 1-16) days, and total hospitalization cost was (6.5±0.8)×10⁴ yuan. There was no readmission within postoperative 30 days. Five patients had intraoperative and posto-perative complications. Of them, one case with intraoperative splenic capsule tear was successfully controlled after hemostatic gauze compression without affecting the procedure. Two cases of bleeding, 1 case of wound infection, and 1 case of pulmonary infection were cured after conservative treatment and discharged from hospital. No severe complication such as gastric leakage occurred, and no reoperation was required. (2) Correlation analysis between BMI and perioperative indicators. Spearman rank correlation analysis showed that preoperative BMI was positively correlated with operation time and volume of intraoperative blood loss (r=0.19, 0.18, P<0.05). Operation time was also positively correlated with volume of intraoperative blood loss (r=0.22, P<0.05). (3) Analysis of influencing factors for operation time. Results of multivariate analysis showed that BMI and conco-mitant procedure were independent influencing factors for operation time (t=2.61, 5.48, 95% confidence interval as 0.24-1.71, 17.70-37.56, P<0.05).

Conclusions Da Vinci robotic sleeve gastrectomy can be safely applied in the treatment of obesity, with a low incidence of perioperative complications. BMI and concomitant procedure are independent influencing factors for operation time of patients.