Early Observations From the Adoption of Robotic Cholecystectomy by an Acute Care Surgery Service

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.