THE IMPACT OF ROBOTIC SURGICAL APPROACH AND PREOPERATIVE COVID-19 DIAGNOSIS ON POST-BARIATRIC-SURGERY COMPLICATIONS

Abstract

Obesity affects more than 40% of adults in the United States and is a significant cause of metabolic disease. Bariatric surgery was one of the most effective means to improve obesity, metabolic disorders, and long-term prognosis. Robotic bariatric surgery (RBS) is increasingly being utilized to improve precision and operative dexterity over laparoscopic bariatric surgery (LBS). In the first paper, we included a total of 798,115 procedures from 2015-2019 to analyze the impact of robotic-assisted versus conventional laparoscopic surgery on postoperative all-cause mortality and surgery-related mortality. Pooled multivariable logistic regression was performed based on imputed data (30 imputations) for a subsampled population to account for the missingness of the covariates. Subgroup analyses were performed to test if the effect of robotic surgery on mortality was consistent across subgroups for each predictor. Since the pandemic COVID-19, millions of surgical procedures have been postponed. However, evidence is conflicting about the risk of postoperative mortality and morbidity in patients with preoperative SARS-CoV-2 infection. In the second paper, we used data from 2021 to analyze the impact of preoperative COVID-19 diagnosis on 30-day mortality, respiratory complications, and all-cause morbidity. We compared the results obtained using a propensity-score matching approach with a traditional multivariable logistic regression model. Considering the paucity of postoperative COVID-19 outcome prediction studies, we identified the predictors for postoperative COVID-19 diagnosis in addition to three primary outcomes.