Retrospective analysis of operative time and time to discharge for laparoscopic vs robotic approaches to appendectomy and cholecystectomy.

Abstract

Robotic-assisted appendectomies and cholecystectomies are believed to increase cost compared to the gold standard laparoscopic approach. Two equally qualified surgeons performed both approaches over 2 years to evaluate intraoperative duration, time to discharge, conversion to open procedure, and readmission within 30days. 110 laparoscopic, 81 robotic-assisted appendectomies; and 105 laparoscopic and 165 robotic-assisted cholecystectomies were performed. Intraoperative time; laparoscopic appendectomy was 1.402 vs 1.3615h for robotic-assisted (P value = 0.304); laparoscopic cholecystectomy was 1.692 vs 1.634h for robotic-assisted (P value = 0.196). Time to discharge, was 38.26 forlaparoscopic vs 28.349h for robotic-assisted appendectomy (P value = 0.010), and 35.95 for laparoscopic vs 28.46h for robotic-assisted cholecystectomy (P value = 0.002). Intraoperative conversion to open; only laparoscopic procedures were converted,one appendectomy and nine cholecystectomies. None in therobotic-assisted procedures. Readmissions, none in the appendectomy group and three in the cholecystectomy group. One laparoscopic and two robotic-assisted cholecystectomy patients were readmitted. Intraoperative times for robotic appendectomy and cholecystectomy were notlonger thanlaparoscopic approach. Robotic approach shortened the time to discharge and the likelihood for conversion to open procedure.