Date of Presentation
5-4-2023 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Introduction/Purpose
Laparoscopic cholecystectomy was first performed in the United States in 1982, and by 1992 it became standard practice. The first robotic cholecystectomy was performed in 1997, yet it still has not been widely accepted as the standard of care. Many research papers early on in the development of robotic-assisted surgery concluded that robotically removing gallbladders would be more costly and less time efficient. We aim to compare the costs and operative time between laparoscopic and robotic cholecystectomy.
Methods
A study was performed on patients who underwent an elective robotic cholecystectomy over one year by a single primary surgeon. Operative time and operative costs were analyzed. This was compared against laparoscopic cholecystectomy performed as usual by surgeons at the same institution. Operative times and costs were also compared in patients who required an intra-operative cholangiogram and those who did not.
Outcomes
Operative Cost: There was no significant difference between the cost of robotic cholecystectomy and laparoscopic cholecystectomy within the same institution. Average Operative Time: There was a significant decrease in robotic cholecystectomy time compared to published and institutional average cholecystectomy time. Operative Time with Cholangiogram: There was a decrease in robotic cholecystectomy time with cholangiogram when compared to the institutional average. Operative Time without Cholangiogram: There was a decrease in robotic cholecystectomy time without cholangiogram when compared to the institutional average.
Conclusion
-As far as we know, this is the first time a prospective study has shown that operative times are decreased when a cholecystectomy is performed robotically when compared to the institutional average for laparoscopic cholecystectomy.
-Intraoperative cholangiogram previously represented a significant barrier in robotic cholecystectomy; however, it can be done in a time-efficient and cost-effective manner.
-As technology and training continue to advance, the barrier to robotic surgery is becoming lower and lower. The time for robotic cholecystectomy to replace laparoscopic cholecystectomy may be now.
Keywords
Cholecystectomy, Robotic Surgical Procedures, Laparoscopic Cholecystectomy, Laparoscopy, Health Care Process Assessment
Disciplines
Digestive System Diseases | Health and Medical Administration | Medicine and Health Sciences | Surgery | Surgical Procedures, Operative
Document Type
Poster
Included in
Digestive System Diseases Commons, Health and Medical Administration Commons, Surgery Commons, Surgical Procedures, Operative Commons
Robotic Cholecystectomy versus Laparoscopic Cholecystectomy: A Modern Analysis of Outcomes and Efficiency
Introduction/Purpose
Laparoscopic cholecystectomy was first performed in the United States in 1982, and by 1992 it became standard practice. The first robotic cholecystectomy was performed in 1997, yet it still has not been widely accepted as the standard of care. Many research papers early on in the development of robotic-assisted surgery concluded that robotically removing gallbladders would be more costly and less time efficient. We aim to compare the costs and operative time between laparoscopic and robotic cholecystectomy.
Methods
A study was performed on patients who underwent an elective robotic cholecystectomy over one year by a single primary surgeon. Operative time and operative costs were analyzed. This was compared against laparoscopic cholecystectomy performed as usual by surgeons at the same institution. Operative times and costs were also compared in patients who required an intra-operative cholangiogram and those who did not.
Outcomes
Operative Cost: There was no significant difference between the cost of robotic cholecystectomy and laparoscopic cholecystectomy within the same institution. Average Operative Time: There was a significant decrease in robotic cholecystectomy time compared to published and institutional average cholecystectomy time. Operative Time with Cholangiogram: There was a decrease in robotic cholecystectomy time with cholangiogram when compared to the institutional average. Operative Time without Cholangiogram: There was a decrease in robotic cholecystectomy time without cholangiogram when compared to the institutional average.
Conclusion
-As far as we know, this is the first time a prospective study has shown that operative times are decreased when a cholecystectomy is performed robotically when compared to the institutional average for laparoscopic cholecystectomy.
-Intraoperative cholangiogram previously represented a significant barrier in robotic cholecystectomy; however, it can be done in a time-efficient and cost-effective manner.
-As technology and training continue to advance, the barrier to robotic surgery is becoming lower and lower. The time for robotic cholecystectomy to replace laparoscopic cholecystectomy may be now.