Charting Progress: Clinical Outcomes and the Learning Curve of Robotic Cholecystectomy in Indian Surgical Practice

Background With the growing use of robotic technology, robotic cholecystectomy (RC) is becoming more common. However, the effect of the learning curve on clinical outcomes in India is yet to be studied. This study addresses that gap by comparing short-term outcomes between two RC cohorts. Methods This study was conducted at a tertiary care center in India, involving 63 patients who underwent RC using the da Vinci Xi system. The patients were divided into two cohorts: cohort 1 included the first 31 cases, and cohort 2 comprised the next 32 cases, based on the learning curve. We evaluated short-term clinical outcomes both preoperatively and postoperatively. Results Patients undergoing RC were relatively young (mean age 45.10 ± 12.73 years) and predominantly female (68.25%). The average body mass index (BMI) was 30.67 ± 5.80 kg/m². The mean operative time of the study population was 37.16 ± 15.45 minutes, with port placement, docking, and console times averaging 1.03 ± 0.23, 0.81 ± 0.41, and 44.20 ± 18.66 minutes, respectively. Only one intraoperative complication (1.58%) occurred, and no conversions to open surgery were required. Postoperatively, there were no complications, bile duct injuries, or surgical site infections. The mean hospital stay was 1.90 ± 1.14 days. The pain scores decreased significantly over time at 6, 24, and 48 hours, and 7 days postoperatively, with no pain reported by day 14. Patients used an average of 2.65 ± 0.63 analgesics over 4.13 ± 1.55 days. Quality of life (QoL) scores improved steadily on postoperative days 3, 14, and 30, with no readmissions or disease recurrence. Cohort 2 showed a significantly reduced docking time (0.70 ± 0.25 vs. 0.93 ± 0.50 minutes, p=0.0269), indicating greater efficiency with experience. Conclusion RC is a feasible and effective option in India, offering improved short-term outcomes, faster recovery, and a learning curve of around 40 cases for experienced laparoscopic surgeons.