Robotic Care Outcomes Project (ROBOCOP) for elective cholecystectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Gastrointestinal Surgery

Background:

• Robotic cholecystectomy (RCHOLE) is increasingly adopted for elective procedures.
• Laparoscopic cholecystectomy (LCHOLE) is the standard minimally invasive approach.
• Comparative outcomes between RCHOLE and LCHOLE require further investigation.

Purpose of the Study:

• To compare clinical outcomes between robotic and laparoscopic cholecystectomy.
• To specifically evaluate the rates of conversion to open or subtotal cholecystectomy.
• To assess complications such as readmissions, hospital-acquired conditions, and bile duct injuries.

Main Methods:

• Retrospective analysis of de-identified electronic health records from 2020-2022.
• Inclusion of elective laparoscopic (LCHOLE) and robotic (RCHOLE) cholecystectomy cases.
• Multivariate Logistic Regression with Inverse Probability Treatment Weighting (MLR/IPTW) to balance covariates.

Main Results:

• Robotic cholecystectomy (RCHOLE) demonstrated significantly lower odds of conversion to open surgery (OR 0.51).
• RCHOLE was associated with reduced odds of readmission (OR 0.89) and hospital-acquired conditions (OR 0.71).
• Bile duct injury was significantly less likely in the RCHOLE group (OR 0.00).

Conclusions:

• Robotic cholecystectomy offers reduced conversion rates to open surgery in elective cases.
• RCHOLE is associated with improved patient outcomes, including fewer readmissions and hospital-acquired conditions.
• The data suggests a potential safety benefit of RCHOLE regarding bile duct injuries compared to LCHOLE.