Robotic compared with laparoscopic cholecystectomy: A National Surgical Quality Improvement Program comparative...

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Comparative Effectiveness Research

Background:

• Clinical benefit data for robotic cholecystectomy versus laparoscopic cholecystectomy are limited.
• Evaluating the comparative outcomes of these two surgical approaches is crucial.

Purpose of the Study:

• To assess if robotic cholecystectomy offers improved surgical outcomes compared to the laparoscopic approach.
• To identify differences in complication rates, conversion rates, and hospitalization durations.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
• Comparison of outcomes for patients undergoing robotic versus laparoscopic cholecystectomy for benign conditions in 2022.
• Multivariable logistic regression analysis to adjust for patient demographics and comorbidities.

Main Results:

• Robotic cholecystectomy was associated with significantly lower rates of Clavien-Dindo grade 3 or 4 complications (OR, 0.82; 95% CI, 0.69-0.98).
• The robotic approach demonstrated a lower rate of conversion to open surgery (OR, 0.44; 95% CI, 0.32-0.61) and reduced odds of hospitalization ≥24 hours (OR, 0.76; 95% CI, 0.71-0.81).
• No significant differences were observed in reoperation or readmission rates between the two techniques.

Conclusions:

• Robotic cholecystectomy is independently linked to reduced serious complications, fewer conversions to open procedures, and shorter hospital stays compared to laparoscopic cholecystectomy.
• These findings indicate that advanced technologies like robotic surgery may improve the safety profile of minimally invasive gallbladder removal.
• Further research into the broader clinical benefits and cost-effectiveness of robotic cholecystectomy is warranted.