Abstract
Background
Laparoscopic cholecystectomy (LC) is the standard procedure for gallbladder disease. Robotic cholecystectomy (RC) has been increasingly adopted; its role within Acute Care Surgery (ACS) services remains undefined. We evaluated early outcomes following the adoption of RC by an ACS service at a Level I trauma center and compared perioperative outcomes with LC.
Methods
A retrospective study revealed all adult patients undergoing LC or RC, emergently or electively, by ACS surgeons at a verified Level I trauma center between January 2024 and 2025. Demographic characteristics, operative indications, body mass index (BMI), operative duration, conversion to open surgery, length of stay (LOS), complications, and 30-day readmission were collected. Categorical variables used Fisher’s exact test and continuous variables utilized Welch’s t-test.
Results
416 cholecystectomies were performed, including 305 LC (73.3%) and 111 RC (26.7%). Mean patient age was 50.3 years and 33.4% were male, with no demographic differences between groups. Robotic cholecystectomy patients had a higher mean BMI (36.0 vs 32.1 kg/m
2
;
P
= 0.002). Operative duration, conversion to open surgery (4.1%), and overall complication rates (10.8%) were similar between LC and RC. Robotic cholecystectomy was associated with shorter LOS (3.02 vs 3.96 days;
P
= 0.031) and lower 30-day readmission rate (4.5% vs 11.5%;
P
= 0.038).
Conclusions
Initial experience with RC by ACS surgeons demonstrated modest reduction in hospital LOS, lower 30-day readmission rates, comparable complication rates relative to LC, and preferential use among patients with higher BMI. Larger prospective studies need to further define RC’s clinical outcomes and value-based implications in the ACS setting.