Robotic vs Laparoscopic Cholecystectomy for Benign Gallbladder Disease: A Comparative Analysis of Early Perioperative Outcomes & Postoperative Analgesia in an Indian Tertiary Care Setting

Abstract

Introduction: Laparoscopic cholecystectomy (LC) remains the reference gold standard for benign gallbladder disease. While robotic cholecystectomy (RC) addresses key ergonomic and visualization constraints of laparoscopy, real-world comparative evidence from the Indian subcontinent remains scarce.

Aim & Objective: This study evaluates early perioperative outcomes and acute postoperative analgesia between multiport RC and multiport LC in an Indian tertiary care setting.

Materials & Methods: A retrospective cohort analysis was conducted on 100 consecutive adult patients who underwent elective, non-complex cholecystectomy for benign disease (50 RC vs. 50 LC) between July 2024 and January 2026 at a single tertiary center in Bengaluru, India. To eliminate inter-operator variability, all procedures were performed by a single surgeon beyond the RC learning curve (>20 cases). Primary endpoints included operative time, intraoperative complications, conversions, surgical site infections (SSIs), length of hospital stay (LOS), 24-hour Numerical Rating Scale (NRS) pain scores, and rescue opioid requirements.

Results: Baseline demographics, BMI, comorbidities, and indications were statistically comparable between groups (p > 0.05). Mean total procedure time was numerically shorter in the LC group without reaching statistical significance (24.56 ± 3.57 vs. 25.38 ± 4.16; p = 0.293). There were zero conversions, bile duct injuries, or 30-day readmissions/mortality in either cohort. SSI rates were statistically equivalent (RC: 2.0% vs. LC: 8.0%; p = 0.362). The RC cohort demonstrated significantly lower 24-hour NRS pain scores (2.76 ± 1.19 vs. 4.48 ± 1.18; p < 0.001) and a marked reduction in rescue opioid requirement (28.0% vs. 74.0%; p < 0.001).

Conclusion: Robotic cholecystectomy is a safe, reproducible alternative to standard laparoscopy in benign gallbladder disease. Beyond procedural equivalence, RC confers a significant opioid-sparing advantage by attenuating early postoperative pain.

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