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.

Authors

Arieli Luz Rodrigues Baretta, Giorgio Alfredo Pedroso Baretta, Verônica Barros, Rafael Schimidt Feistler, Flávio Panegalli Filho, Carolina Mocellin Ghizoni, Alexandre Coutinho Teixeira de Freitas

Published in

Journal of robotic surgery. Volume 20. Issue 1. Jul 20, 2026. Epub Jul 20, 2026.

Abstract

Obesity is a chronic and multifactorial disease associated with systemic changes and pulmonary impairment. 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 18-65 years with body mass index (BMI) 40.0-49.9 kg/m² 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 [FEV₁], and FEV₁/FVC ratio), manovacuometry (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]), and physical activity level (International Physical Activity Questionnaire-Short Form [IPAQ-SF]), following ATS/ERS standards. Statistical analyses included chi-square, Fisher's exact, Student's t, Mann-Whitney U, and mixed-effects models (p < 0.05). A total of 98 patients were included (49 L-, 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.

PMID:
42474908
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

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