Robotics, money and research: is data or physician payments driving robotic bariatric surgery literature?

Introduction: Physician payments from Intuitive Surgical have increased from 37 million to over 53 million per year since 2018. The study was completed to determine the accuracy of conflict of interest (COI) statements and the influence of industry payments on the valuation of the robotic platform.

Methods: PubMed and Medline search for "robotic, robotic assisted" and "bariatric, Gastric Bypass, Sleeve Gastrectomy, Biliopancreatic Diversion, and Single Anastomosis Duodeno-Ileal Bypass". Manuscripts on robotic bariatric surgery with a US author with an electronic publication (EPub) date between 2018 and 2022 were included. Manuscripts were reviewed for disclosure of COI. The manuscripts were reviewed by two reviewers. The Introduction, Results, and Discussion/Conclusion were scored as Robotic Unfavorable, Neutral, or Robotic Favorable. https://OpenPaymentsData.CMS.gov was reviewed for physician payments 1 year prior and 1 year following the EPub date.

Results: Robotic favorable manuscripts were significantly less likely to have an adequate COI. Authors of robotic favorable manuscripts were significantly more likely to have a COI. Authors of robotic favorable manuscripts had significantly a higher Intuitive physician compensation. In addition, authors of robotic favorable manuscripts were significantly more likely to have an increase in the amount of compensation by Intuitive Surgical the following year.

Conclusion: Our findings suggest that Intuitive open payments have significantly influenced favorable reports in robotic bariatric literature. The submission of open payments data, to include compensation amounts should be required for manuscript publication or acceptance to surgical conferences.