Robotic Cholecystectomy Remains Safe and Effective After Regular Staffing Hours

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Robotic-assisted surgery is increasingly adopted in various surgical fields.
• Access to robotic platforms during off-peak hours (evenings/weekends) for urgent procedures is often limited due to safety concerns.
• Acute calculous cholecystitis is a common urgent surgical indication.

Purpose of the Study:

• To compare outcomes of robotic cholecystectomy performed during regular hours versus after-hours (evenings/weekends).
• To evaluate the safety and efficacy of after-hours robotic cholecystectomy for acute calculous cholecystitis.
• To determine if restricting robotic platform access during off-peak hours is clinically justified.

Main Methods:

• Retrospective analysis of 46 patients undergoing robotic cholecystectomy for acute calculous cholecystitis (2018 Tokyo criteria).
• Patients were categorized into 'regular-hours' (n=20) and 'after-hours' (n=26) groups based on operation start time.
• Comparison of demographic, perioperative variables, and patient outcomes between the two groups.

Main Results:

• No significant differences were observed in demographic or perioperative variables (BMI, age, ASA score, WBC count) between after-hours and regular-hours cohorts.
• Operative time, estimated blood loss, and length of stay were comparable between the groups.
• No mortalities occurred; one unrelated readmission was noted in the after-hours group.

Conclusions:

• Robotic cholecystectomy for acute calculous cholecystitis can be performed safely and effectively during evenings and weekends.
• The findings support the justification for making robotic surgical platforms available during after-hours periods.
• Hospitals should consider expanding access to robotic surgery during off-peak times to meet patient needs.