Robotic vs Laparoscopic Bariatric Surgery: Insights from Australia’s National Registry
Robots are increasingly being used to conduct weight loss surgery, without much evidence of drawbacks or benefits. Now, a new national study has evaluated safety outcomes in Australia, comparing robotic bariatric surgery with the more traditional laparoscopic (keyhole) approach.
Professor Wendy Brown, head of Surgery - Alfred at Monash Translational Medicine, and PhD candidate Yit Leang, used data from the Australia and New Zealand Bariatric Surgery Registry to review nearly 66,000 cases of weight loss surgery, also known as metabolic and bariatric surgery (MBS). Of these procedures, 910 (1.4 per cent) were performed using robotic technology.
“Early on, there were concerns that robotic surgery might carry more risks,” Professor Brown said. “But when we adjusted for things like the type of surgery and patient health, the outcomes between robotic and laparoscopic surgery were actually very similar.”
The circumstances under which robotic platforms are used was crucial.
In this study, the robotic group had a higher proportion of complex and revisional procedures — surgeries done to fix or adjust a previous one.
“These were not simple cases,” Professor Brown explained. “Robotic surgery was more often used for bypasses and revision procedures, which are naturally more complex and carry higher risks.”
To ensure a fair comparison, the researchers used a method called “propensity score matching.” This technique creates a level playing field by matching patients in both groups based on factors like age, body mass index (BMI), diabetes status, and the type of procedure.
Once this matching was done, the study found no significant difference in rates of complications, hospital readmissions, or deaths between robotic and laparoscopic surgeries.
“This is reassuring,” Mr Leang said. “It tells us that the robot itself doesn’t add risk when used by experienced surgeons, even during the learning phase.”
A Tool, Not a Substitute
However, Professor Brown cautions that the robot is a tool — not a decision-maker.
“It’s still the surgeon doing the operation,” Professor Brown said. “The robot enhances visualisation and instrument control, but the procedure itself remains unchanged.”
“Surgeons with established experience in laparoscopic techniques can transition safely to the robotic platform with appropriate training.”
Although robotic surgery is gaining traction, it is still performed by a minority of bariatric surgeons in Australia. The study found that surgeons using robotic platforms were often early in their learning curve with this technology, yet outcomes were still comparable to traditional methods.
“This is reassuring,” said Professor Brown. “It demonstrates that, when used responsibly by skilled surgeons, robotic surgery does not increase the risk of adverse events.”
Obesity affects millions of Australians, and bariatric surgery is often a life-changing option. As hospitals invest in new robotic systems, it is critical to ensure patient safety remains a top priority.
“There’s been a lot of excitement about robotic platforms, and rightly so,” Professor Brown said. “But we need to make sure we’re adopting these tools in a way that’s safe and evidence-based.”
To that end, the team has launched a new national, multi-centre trial to study how surgeons perform specific parts of the operation using robotic versus laparoscopic tools. Video analysis and technical scoring will be used to better understand subtle differences.
This study, published in the Journal of Robotic Surgery, is the first large-scale look at robotic bariatric surgery outcomes in Australia, using a national clinical quality registry.
Robotic surgery appears safe, even for complex procedures, when performed by trained surgeons. But like any new technology, it needs to be introduced carefully.
“The evidence supports the safe integration of robotic technology into bariatric surgical practice,” Professor Brown said. “But this must be accompanied by continued evaluation, ethical oversight, and a commitment to high standards of care.
“We need structured training, strong credentialling, and ongoing monitoring,and patient safety must always come first.”
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
For more news, visit Medicine, Nursing and Health Sciences or Monash University.
MEDIA ENQUIRIES