In-Hospital Outcomes of Robotic-Assisted Cholecystectomy in Obese versus Normal-Weight Patients: A National Inpatient...

Area of Science:

• Minimally Invasive Surgery
• Bariatric Surgery Outcomes
• Gastrointestinal Surgery

Background:

• Obesity is linked to increased risks and technical challenges in cholecystectomy.
• Robotic-assisted cholecystectomy (RC) offers potential advantages for managing obese patients.

Purpose of the Study:

• To compare in-hospital outcomes of RC between obese and normal-weight patients.
• To evaluate the safety and efficacy of RC in an obese population.

Main Methods:

• Retrospective analysis of National Inpatient Sample data (2016-2021).
• Inclusion of 15,048 adult patients undergoing RC, stratified into obese (BMI ≥30 kg/m²; n=4570) and normal-weight (BMI 18-25 kg/m²; n=10,478) groups.
• Analysis of demographics, comorbidities, hospital characteristics, and in-hospital outcomes using multivariable models.

Main Results:

• Obese patients (30% of cohort) were younger and had significantly lower in-hospital mortality (aOR 0.27) and infection rates (aOR 0.33).
• No significant differences were observed in other complication rates or rates of conversion to open surgery.
• RC appears safe and effective in selected obese individuals undergoing cholecystectomy.

Conclusions:

• Robotic-assisted cholecystectomy is increasingly utilized in obese patients and demonstrates safety in carefully selected individuals.
• Obese patients undergoing RC exhibit lower in-hospital mortality and comparable complication rates to normal-weight patients, despite higher comorbidity burdens.
• Further research is needed to address potential selection bias and evaluate long-term outcomes.