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Published on: March 27, 2026
Robotic-assisted cholecystectomy in children is associated with faster gastrointestinal recovery: a comparative study
M Di Mitri1, M M Cantagalli1,2, A Morabito1,3
1Department of Pediatric Surgery, Meyer Children's Hospital, Florence, Italy.
Insights
Robotic-assisted cholecystectomy in children is safe and feasible, showing faster bowel function recovery and shorter hospital stays compared to traditional laparoscopy. Further studies are needed to confirm its role in pediatric surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Robotics
Background:
- The role of robotic-assisted cholecystectomy in pediatric patients requires further definition.
- Existing research lacks comprehensive data on postoperative recovery and gastrointestinal function in children undergoing this procedure.
Purpose of the Study:
- To compare perioperative outcomes and early recovery between robotic-assisted and conventional laparoscopic cholecystectomy in pediatric patients.
- To evaluate the safety and efficacy of robotic surgery in children undergoing gallbladder removal.
Main Methods:
- A retrospective comparative cohort study involving 28 pediatric patients (≤18 years) undergoing cholecystectomy.
- Patients were divided into pre-robotic and robotic groups based on surgical approach.
- Demographic, intraoperative, and postoperative outcomes were analyzed using Mann-Whitney U and Fisher's exact tests.
Main Results:
- Robotic cholecystectomy had longer operative times (2:22h vs. 1:33h) but resulted in significantly shorter hospital stays (2 vs. 4 days).
- Early oral feeding (100% vs. 69.2%) and passage of flatus (93.3% vs. 30.8%) within 24 hours were significantly improved in the robotic group.
- Postoperative complications and surgical site infections were rare and comparable between groups.
Conclusions:
- Robotic-assisted cholecystectomy is a safe and feasible option for pediatric patients.
- The robotic approach offers advantages in terms of shorter hospital stay and accelerated gastrointestinal recovery.
- Larger prospective studies are warranted to solidify the role of robotics in pediatric cholecystectomy.
Background:
The role of robotic-assisted cholecystectomy in paediatric patients remains incompletely defined, particularly regarding postoperative recovery and gastrointestinal function. This study aimed to compare perioperative outcomes and early recovery between robotic-assisted and conventional laparoscopic cholecystectomy in children.
Methods:
A single-centre retrospective comparative cohort study was conducted at a tertiary paediatric referral centre. Consecutive patients (≤18 years) undergoing cholecystectomy for benign gallbladder disease were included and divided into two groups based on surgical approach: pre-robotic (January 2023-December 2024) and robotic (January 2025-December 2025). Demographic, intraoperative, and postoperative outcomes were analysed. Continuous variables were compared using the Mann-Whitney U test and categorical variables using Fisher's exact test.
Results:
A total of 28 patients were included (13 pre-robotic, 15 robotic). Baseline characteristics were comparable between groups. Median operative time was significantly longer in the robotic group (2:22 h vs. 1:33 h; p < 0.001), while length of hospital stay was significantly shorter (2 vs. 4 days; p = 0.003). No conversions to open surgery or surgical site infections were observed. Postoperative complications were rare and comparable between groups (7.7% vs. 0%; p = 0.46). Analgesic requirements, VAS scores, and PEWS values were similar. Early gastrointestinal recovery was significantly improved in the robotic group. Early oral feeding within 24 h occurred in 100% of robotic cases versus 69.2% in the pre-robotic group (p = 0.041). Passage of flatus within 24 h was observed in 93.3% versus 30.8%, respectively (p = 0.002).
Conclusions:
Robotic-assisted cholecystectomy is a safe and feasible approach in paediatric patients, with perioperative outcomes comparable to conventional laparoscopy. Despite longer operative times, the robotic approach was associated with shorter hospital stay and faster recovery of bowel function. These findings suggest a potential advantage of robotic surgery in promoting early postoperative recovery. Larger prospective studies are needed to confirm these results and define the role of robotics in paediatric cholecystectomy.