Conclusion
Robotic assistance is used in a small percentage of bariatric procedures in the US. The major limitation of our analysis is the lack of studies and their low quality, small sample size,, heterogeneity of enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported from actual evidence. According to our experience the major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy). According to our experience the major disadvantage of the robotic bariatric surgery "still remains the high operational and acquisition cost of the system".