Robotic Versus Laparoscopic Cholecystectomy: Operative Time and Conversion in Urgent Cases
Maral Peisepar1, Kartik Prabhakaran1, Rishwanth Vetri1
1Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
Introduction:
Robotic cholecystectomy has gained increased adoption as an alternative to conventional laparoscopic cholecystectomy. However, evidence regarding its operative efficiency and conversion to open surgery remains incomplete, particularly when comparing elective and urgent cases.
Methods:
We conducted a retrospective cohort study of 350 consecutive patients who underwent minimally invasive cholecystectomy at a level I trauma center. Procedures were categorized by surgical approach (laparoscopic or robotic) and operative indication (elective or urgent). The World Society of Emergency Surgery grading system was used to classify disease severity.
Results:
Among 350 patients, 184 underwent laparoscopic cholecystectomy and 166 underwent robotic cholecystectomy. In elective cases, operative time was comparable between robotic and laparoscopic approaches (93.0 versus 91.0 min, P = 0.748). No conversions to open surgery occurred in elective cases for either approach. In urgent cases, operative time increased compared with elective procedures in both groups. Conversion occurred more frequently in laparoscopic urgent operations (3.7%) compared with robotic urgent operations (1.9%). Conversions occurred almost exclusively in grade D diseases.
Conclusions:
For elective cholecystectomy, robotic and laparoscopic approaches demonstrate comparable operative efficiency with no conversions. In urgent cholecystectomy, the robotic approach achieved similar operative time and a lower conversion frequency. These findings support the use of robotic cholecystectomy as an effective alternative for both elective and urgent gallbladder disease, with potential benefit in high-severity urgent cases.
