ROBOtic Care Outcomes Project for acute gallbladder pathology.

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Gastrointestinal Surgery

Background:

• Robotic cholecystectomy use is rising for acute gallbladder disease in emergency settings.
• Limited clinical evidence exists comparing robotic to laparoscopic approaches.
• This study addresses the need for real-world data on emergent cholecystectomies.

Purpose of the Study:

• To compare outcomes of emergent robotic versus laparoscopic cholecystectomies.
• To evaluate conversion rates, complications, and costs.
• To provide evidence for clinical decision-making in acute gallbladder disease.

Main Methods:

• Analysis of a large real-world database (2020-2022) of emergent cholecystectomies.
• Utilized electronic health record data from US hospitals.
• Employed multivariate logistic regression with inverse probability treatment weighting (IPTW) for outcome comparison.
• Defined outcomes using ICD-10 and/or CPT codes.

Main Results:

• Robotic cholecystectomy significantly decreased odds of conversion to open surgery (OR 0.68).
• Robotic approach increased odds of subtotal cholecystectomy (OR 1.64).
• No significant differences observed in surgical site infections, readmissions, length of stay, or mortality.
• Hospital costs were comparable between robotic and laparoscopic groups.

Conclusions:

• Robotic cholecystectomy offers reduced conversion to open surgery for acute gallbladder disease.
• It is associated with an increased rate of subtotal cholecystectomy.
• Complication profiles and hospital costs are similar to laparoscopic cholecystectomy.