Robotic vs. Laparoscopic Cholecystectomy: Study finds No Clear Advantage for Robotic Approach

The primary outcome was bile duct injury, a severe complication that may cause considerable morbidity. Secondary outcomes comprised postoperative complications, hospital stay, and postoperative drain use.

Key Findings

The study revealed no significant difference in bile duct injury rates between the two surgical methods:

• Bile duct injury occurred in 0.37% (128 of 35,037) of robotic-assisted cases vs 0.39% (138 of 35,037) of laparoscopic cases

• Odds Ratio (OR): 0.93

• 95% Confidence Interval (CI): 0.73–1.18

• P = 0.54 (not statistically significant)

However, robotic-assisted cholecystectomy was associated with worse outcomes in several other important measures:

• Major postoperative complications were significantly higher:

• 8.37% (2,934 of 35,037) in the robotic group vs 5.50% (1,926 of 35,037) in the laparoscopic group

• OR: 1.57; 95% CI: 1.48–1.67; P < 0.001

Postoperative drain use was also greater with robotic surgery:

• 0.63% (219 of 35,037) vs 0.48% (132 of 35,037)

• OR: 1.66; 95% CI: 1.34–2.07; P < 0.001

• Median hospital stay was longer for robotic patients:

• 3 days (interquartile range [IQR]: 2–4) vs 2 days (IQR: 1–4); P < 0.001

Robotic-assisted and laparoscopic cholecystectomy were shown to have equivalent bile duct injury rates in acute care surgery. Robotic-assisted surgery, however, had greater complication rates, longer lengths of stay, and more drainage use. These results indicate that, in its current state of development and use, robotic-assisted cholecystectomy does not have a clear benefit over conventional laparoscopic techniques.

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