{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:55:49Z","timestamp":1791384949695,"version":"4.3.3"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robotic-assisted surgery (RAS) is increasingly used in bariatric practice, yet its impact on outcomes after duodenal switch (DS) remains poorly characterized, and whether operative length (OL) modifies the RAS-outcome association has not been assessed. The present study examines the independent and interactive effects of RAS and OL on 30-day readmission after DS using a national cohort of over 17,000 cases from the MBSAQIP database spanning 2015\u20132024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed MBSAQIP data from 2015 to 2024 for patients undergoing laparoscopic DS (CPT 43845), excluding open, endoscopic, hand-assisted, and single-incision, revision, and conversion cases. Multivariable logistic regression assessed predictors of 30-day readmission, with a pre-specified interaction term between RAS and standardized OL to isolate the independent contribution of robotic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 17,615 DS cases, 5,496 (31.2%) were robotic-assisted. Thirty-day readmission was higher after RAS than laparoscopic DS (6.2% vs. 5.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). In adjusted models, RAS (OR 1.78, 95% CI 1.25\u20132.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and OL (OR 1.27 per standard deviation (SD), 95% CI 1.18\u20131.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with increased odds of readmission. The RAS\u2013OL interaction significantly improved model fit (likelihood ratio\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007); each SD decrease in OL increased the relative readmission risk for RAS versus laparoscopic cases (interaction OR 0.79, 95% CI 0.67\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Temporal subgroup analysis shows this disadvantage was concentrated in 2015\u20132019.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RAS for DS is associated with higher 30-day readmission, and OL significantly modifies this relationship. The interaction term suggests that improved operative efficiency will not resolve the RAS readmission disadvantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08921-w","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:24:39Z","timestamp":1788229479000},"page":"5388-5395","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic Use, Operative Length, and Readmission after Duodenal Switch: A Retrospective Ten-Year MBSAQIP Analysis Using an Interaction Model"],"prefix":"10.1007","volume":"36","author":[{"given":"Samuel","family":"Leslie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4390-9962","authenticated-orcid":false,"given":"Sruthi","family":"Shankar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Sauve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amogh","family":"Kalyanam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayeed","family":"Ikramuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Wise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"issue":"4","key":"8921_CR1","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s11695-012-0864-0","volume":"23","author":"H Buchwald","year":"2013","unstructured":"Buchwald H, Oien DM. Metabolic\/Bariatric Surgery Worldwide 2011. Obes Surg. 2013;23(4):427\u201336. https:\/\/doi.org\/10.1007\/s11695-012-0864-0.","journal-title":"Obes Surg"},{"issue":"1","key":"8921_CR2","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/XCS.0000000000000246","volume":"235","author":"K Ho","year":"2022","unstructured":"Ho K, Hsu CH, Maegawa F, Ashouri Y, Ho H, Ajmal S, et al. Operative Time and 30-Day Outcomes in Bariatric Surgery: Comparison between Robotic and Laparoscopic Approach: 4-Year MBSAQIP Database Analysis. J Am Coll Surg. 2022;235(1):138\u201344. 10. 1097\/XCS.0000000000000246 PubMed PMID: 35703971.","journal-title":"J Am Coll Surg"},{"issue":"11","key":"8921_CR3","doi-asserted-by":"publisher","first-page":"4744","DOI":"10.1007\/s11695-025-08313-6","volume":"35","author":"M Alomari","year":"2025","unstructured":"Alomari M, Dahiya R, Spaulding A, Edwards MA. Impact of Increasing Robotic Bariatric Utilization on Duodenal Switch Procedure Outcomes. 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