Robotic cholecystectomy reduces the conversion rate in patients with obesity

Obesity is associated with technical challenges during laparoscopic cholecystectomy (LC) and a high risk of intra-postoperative complications. Robotic-assisted cholecystectomy (RC), with its superior visualization and precision, may offer better outcomes. This study compares intraoperative and 30-day postoperative outcomes in patients with a BMI greater than 30 undergoing LC versus RC.

Patients with a BMI greater than 30 who underwent LC and RC at our institution from January 2021 to May 2024 were included to compare outcomes such as conversion rate, length of stay, and operative time between groups. Then, we conducted a subgroup analysis comparing LC patients who required conversion to open surgery with those who did not to compare outcomes.

637 patients were included (505 LC and 132 RC). RC patients had lower rates of conversion to open surgery (0.0 % vs. 3.2 %, P = 0.038) and shorter hospital stays (1 [0.5-2] vs. 1 [1-2] days, P < 0.001) compared to LC. When sub-analyzed patients LC patients, those who required conversion to open surgery had a longer length of stay (4 [3-6.5] vs. 1 [1-2] days, P < 0.001), and operative time (224.31 ± 88.17 vs. 104.27 ± 37.88 min, P < 0.001) compared to those who did not require conversion.

Patients with obesity who underwent RC have reduced conversion to open rates compared to LC. Furthermore, a reduced conversion to open rate with RC potentially leads to a shorter hospital stay. RC offers better postoperative outcomes in patients with obesity.