Robot-assisted cholecystectomies take less time to perform than laparoscopy in the urgent setting: a single-centered...

Despite numerous technical advantages of robotic cholecystectomy, laparoscopy remains the standard approach. Arguments for laparoscopy include decreased time to perform surgery. However, in light of the increased familiarity with robotic technology, we sought to evaluate the time of elective and urgent laparoscopic as compared to robotic cholecystectomies. Our study included all cholecystectomies performed at a tertiary care center from 2017 to 2020. 31 surgeons performed laparoscopic cases, and 5 surgeons performed robotic cases. Cases that began open or were planned combined procedures were excluded. Elective and urgent cases were evaluated for total operating room (OR) time. 747 laparoscopic and 160 robotic cholecystectomies were performed in the study's time period. Patient demographics and comorbidities were not statistically different between groups. The median total in OR time was 114 min for laparoscopic compared to 107.5 min for robotic cholecystectomy (p = 0.03). Although median OR time for elective laparoscopic and robotic cases was similar (p = 0.33), urgent laparoscopic cholecystectomies for acute cholecystitis were significantly longer than robotic cases (118 min vs. 106.5 min, p = 0.04). Conversion to open rate was 3.4% for laparoscopic and 0.6% for robotic cholecystectomies (p = 0.03). 30-day readmission rate was equivalent between the groups (p = 0.75). There were no deaths or common bile duct injuries within 30 days. While the total OR time for robotic and laparoscopic cholecystectomy is similar for elective cases, the robot is more efficient when performing cholecystectomy in the urgent setting. This finding differs from previously published studies and suggests a role for urgent robotic cholecystectomy.