A Retrospective Analysis of Short-Term Outcomes of Robotic and Laparoscopic Cholecystectomy: An Indian Tertiary Care Comparative Experience.

Background There has been a gradual adoption of general surgery robotic programs in India. However, we still do not have a single comparative study reporting the initial experience of robotic cholecystectomy (RC) compared to laparoscopic cholecystectomy (LC). This retrospective study is aimed at addressing this clinical data gap. Methods This is a retrospective medical chart review where data related to patient demographics, and intraoperative and postoperative outcomes were collected. All patients underwent either RC or LC for gallstone disease, performed by a single surgeon from January 2020 to September 2023. The surgeon had passed the learning curve for RC and this data collection reflects his post-learning curve experience. Results A total of 100 cases (RC: 50; LC: 50) were collected. Baseline parameters such as age, sex, BMI, and comorbidities were comparable. There were no conversions from the planned procedure in either of the groups (0% vs 0%). There were no intraoperative complications such as bleeding or common bile duct injury (0% vs 0%). The rates of surgical site infections (SSIs) were numerically lower in the robotic group, 2% vs 6% (p = 0.3099). There were no postoperative complications in the robotic group, whereas one patient in the laparoscopic group experienced port side bleeding (0% vs 2%, p = 0.3173). The mean length of hospital stay was one day in both groups. The mean pain score 24- hours after the surgery was 1.78 ± 0.68 in the robotic group and 3.3 ± 1.2 in the laparoscopic group (p = <0.001). None of the patients required opioid analgesics in the robotic group, whereas 20% of patients in the laparoscopic group needed at least one dose of opioid analgesics (p = 0.0009). There were no reoperations reported in the robotic group, whereas the laparoscopic group reported 1 case. The 30-day mortality was nil in both groups. Conclusion RC is feasible in Indian settings. Compared to LC, it does not increase morbidity. The improvement in acute postoperative pain can potentially allow early ambulation and recovery. A larger multicentric study, comparing RC to LC in India will validate our initial experience.