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Roux-en-Y gastric bypass (RYGB) is effective in treating severe obesity and has been associated with improvements in pulmonary function; however, evidence comparing the effects of laparoscopic (L) and robotic-assisted (RA) RYGB on respiratory outcomes remains limited. To compare the effects of L- and RA- RYGB on lung function, respiratory muscle strength and physical activity level, at baseline and six months postoperatively. Prospective, non-randomized study conducted at a private bariatric surgery center in Brazil, including patients of both sexes, aged 18\u201365 years with body mass index (BMI) 40.0\u201349.9\u00a0kg\/m\u00b2 undergoing Roux-en-Y gastric bypass. Patients with a history of smoking or pre-existing pulmonary disease were excluded. Patients were divided into L- and RA- groups and evaluated at baseline and six months after surgery with spirometry (forced vital capacity [FVC], forced expiratory volume in one second [FEV\u2081], and FEV\u2081\/FVC ratio), manovacuometry (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]), and physical activity level (International Physical Activity Questionnaire\u2013Short Form [IPAQ-SF]), following ATS\/ERS standards. Statistical analyses included chi-square, Fisher\u2019s exact, Student\u2019s t, Mann-Whitney U, and mixed-effects models (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). A total of 98 patients were included (49\u00a0L-, 49 RA-), with 84 completing the six-month follow-up. Among those who completed follow-up, most participants were women (75.0%), with a mean age of 37.3 years. Significant improvements in pulmonary function were observed over time following surgery. Although a reduction in maximal expiratory pressure was observed in the laparoscopic group in within-group analyses, mixed-effects models showed no significant differences between surgical approaches regarding respiratory muscle strength, pulmonary function, physical activity level, or longitudinal changes over time. Laparoscopic and robotic-assisted Roux-en-Y gastric bypass were associated with improved pulmonary function six months after surgery, with no significant differences between surgical approaches in respiratory outcomes or physical activity level.\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03641-w","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:31:29Z","timestamp":1784539889000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic (L-) versus Robotic Assisted (RA-) Roux-en-y Gastric Bypass (RYGB): effects on lung function, respiratory muscle strength, and physical activity after six months"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2237-3209","authenticated-orcid":false,"given":"Arieli Luz Rodrigues","family":"Baretta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-6663","authenticated-orcid":false,"given":"Giorgio Alfredo Pedroso","family":"Baretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6054-5772","authenticated-orcid":false,"given":"Ver\u00f4nica","family":"Barros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9865-607X","authenticated-orcid":false,"given":"Rafael Schimidt","family":"Feistler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5275-5592","authenticated-orcid":false,"given":"Fl\u00e1vio Panegalli","family":"Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-4622","authenticated-orcid":false,"given":"Carolina Mocellin","family":"Ghizoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-4940","authenticated-orcid":false,"given":"Alexandre Coutinho Teixeira","family":"de Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"13","key":"3641_CR1","doi-asserted-by":"publisher","first-page":"7349","DOI":"10.3390\/ijms23137349>","volume":"23","author":"G Palma","year":"2022","unstructured":"Palma G, Sorice GP, Genchi VA et al (2022) Adipose tissue inflammation and pulmonary dysfunction in obesity. 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