Seven studies (1,686 patients) were included in the review. Sample sizes ranged from 20 to 676 patients. One study was a randomised controlled trial of 50 patients; the remaining studies were comparative studies. There was little information provided on follow-up in the review but the authors stated there was a minimum of six months.
There were no significant differences between groups in the incidence of anastomotic leak between the robotic and standard laparoscopic Roux-en-Y gastric bypass groups. There were no differences reported for the comparison between robotic assisted surgery and stapled laparoscopy. There was insufficient data to analyse the comparison with sutured laparoscopy.
There were statistically significant reductions in anastomotic stricture observed with robotic surgery compared with laparoscopic (OR 0.43, 95% CI 0.19 to 0.98, three studies, 1,299 patients). There were no significant differences observed when robotic-assisted techniques were compared with stapled laparoscopic surgery and there was insufficient evidence to pool data for the comparison of robotic surgery with laparoscopic surgery using sutures.
There were no significant differences between standard and laparoscopic Roux-en-Y gastric bypass surgery observed for the incidence of post-operative complications, operative time and length of hospital stay.
Where calculated, there was no evidence of statistical heterogeneity across the included studies, except for operative time. There was no evidence of publication bias observed for the outcomes.