Bedside Stapling in Robotic Bariatric Surgery: A Cheaper, Safer Option?

A new study is shaking up the world of robotic bariatric surgery by showing that a technique called “bedside stapling”—which involves using laparoscopic staplers manually at the patient’s bedside—could be just as effective as robotic staplers, but with a lot of added benefits. In fact, the study found that bedside stapling leads to fewer ICU stays, shorter hospital visits, and lower overall healthcare costs.

Dr. Alexander Abkin, a bariatric surgeon based in New Jersey, emphasizes that this finding could help make bariatric surgeries like gastric bypass or sleeve gastrectomy more accessible to patients in smaller hospitals, where resources may be more limited.

“Most patients who undergo bariatric surgery are looking for effective treatment at a lower cost,” Dr. Abkin says. “If bedside stapling can achieve the same results with fewer complications and lower healthcare utilization, it’s a win for both patients and the healthcare system.”

What Is Bedside Stapling?

In robotic bariatric surgery, staplers are used to secure parts of the stomach and intestines. Traditionally, robotic staplers—controlled by a robotic arm—have been seen as the gold standard. However, the new study compares robotic staplers with “bedside staplers,” which are manually controlled but still used during minimally invasive, robotic-assisted surgery. The key finding is that bedside staplers are just as effective, but they come with a significant reduction in costs and complications.

The Study’s Findings

In a large-scale study analyzing over 7,200 patients who had bariatric surgery in 2021, researchers found that patients who had bedside stapling were less likely to experience complications like needing a blood transfusion or staying in the ICU. In fact, these patients spent less time in the hospital overall, which meant lower healthcare costs.

Comparing the Two Techniques

The study compared two groups: one group used bedside staplers (1,603 patients), and the other used robotic staplers (5,665 patients). The results were eye-opening:

• Patients using robotic staplers were more likely to need blood transfusions and stay in the ICU. They also had longer surgery times and higher costs.
• Patients using bedside staplers had fewer ICU stays, shorter surgeries, and overall lower healthcare costs, even when accounting for differences in patient backgrounds.

Dr. Abkin agrees, saying, “It’s clear from the study that bedside stapling offers an opportunity to improve efficiency in surgery. The reduction in ICU stays and overall hospital costs is significant. This is crucial, especially in a healthcare landscape that’s becoming more focused on cost-effectiveness.”

What Does This Mean for the Future?

The study’s findings could have a major impact on how bariatric surgery is performed in the future. Bedside stapling could be a game-changer, particularly in smaller hospitals or places with limited access to high-end robotic technology. Dr. Billy’s study shows that the procedure is not only effective, but also more affordable, making it a potentially sustainable option for a broader range of healthcare settings.

In fact, Dr. Billy noted that bedside stapling might become a common practice as healthcare providers look to cut costs without compromising patient safety or outcomes. “As we move toward more cost-effective and efficient healthcare, bedside stapling is a promising option, especially in smaller hospitals where robotic systems might not be available,” he said.

The study highlights that bedside stapling could be a more affordable and just as effective alternative to robotic stapling in bariatric surgery. Fewer ICU stays, shorter hospitalizations, and lower costs could make this technique particularly attractive to hospitals looking to offer quality care without the high price tag. As Dr. Abkin puts it, “With healthcare costs rising, anything that can reduce the financial burden while still delivering top-notch care is a win for everyone involved.”

So, while robotic surgery still has its place, the future of bariatric surgery might just be going back to basics with a twist—and it’s looking like bedside stapling is here to stay.