Robotic cholecystectomy reduces the conversion rate in patients with obesity.

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland Pub Date : 2025-07-12 DOI:10.1016/j.surge.2025.07.004

Raul Sebastian, Alba Zevallos, Diana Montenegro, Lourdes Chaves, Pamela Sullivan, James Harris

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引用次数: 0

Abstract

Background: Obesity is associated with technical challenges during laparoscopic cholecystectomy (LC) and a high risk of intra-postoperative complications. Robotic-assisted cholecystectomy (RC), with its superior visualization and precision, may offer better outcomes. This study compares intraoperative and 30-day postoperative outcomes in patients with a BMI greater than 30 undergoing LC versus RC.

Methods: Patients with a BMI greater than 30 who underwent LC and RC at our institution from January 2021 to May 2024 were included to compare outcomes such as conversion rate, length of stay, and operative time between groups. Then, we conducted a subgroup analysis comparing LC patients who required conversion to open surgery with those who did not to compare outcomes.

Results: 637 patients were included (505 LC and 132 RC). RC patients had lower rates of conversion to open surgery (0.0 % vs. 3.2 %, P = 0.038) and shorter hospital stays (1 [0.5-2] vs. 1 [1-2] days, P < 0.001) compared to LC. When sub-analyzed patients LC patients, those who required conversion to open surgery had a longer length of stay (4 [3-6.5] vs. 1 [1-2] days, P < 0.001), and operative time (224.31 ± 88.17 vs. 104.27 ± 37.88 min, P < 0.001) compared to those who did not require conversion.

Conclusion: Patients with obesity who underwent RC have reduced conversion to open rates compared to LC. Furthermore, a reduced conversion to open rate with RC potentially leads to a shorter hospital stay. RC offers better postoperative outcomes in patients with obesity.

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机器人胆囊切除术降低肥胖患者的转换率。

背景：肥胖与腹腔镜胆囊切除术（LC）中的技术挑战和术后并发症的高风险相关。机器人辅助胆囊切除术（RC），其优越的可视化和精度，可能提供更好的结果。这项研究比较了BMI大于30的LC和RC患者的术中和术后30天的结果。方法：纳入2021年1月至2024年5月在我院接受LC和RC治疗的BMI大于30的患者，比较两组之间的转换率、住院时间和手术时间等结果。然后，我们进行了亚组分析，比较了需要转换为开放手术的LC患者和不需要转换为开放手术的患者的结果。结果：纳入637例患者（505例LC， 132例RC）。RC患者转开腹率较低（0.0% vs. 3.2%, P = 0.038），住院时间较短(1 [0.5-2]vs. 1[1-2]天，P结论：与LC相比，接受RC的肥胖患者转开腹率降低。此外，RC降低了转换到打开率，可能会缩短住院时间。RC为肥胖患者提供了更好的术后预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 医学-外科

CiteScore

4.40

自引率

0.00%

发文量

158

审稿时长

6-12 weeks

期刊介绍： Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field. Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.