LAPAROSCOPIC VERSUS ROBOTIC CHOLECYSTECTOMY: A SYSTEMATIC REVIEW OF COMPLICATIONS AND COST-BENEFIT

Abstract

Laparoscopic cholecystectomy is considered the gold standard for the treatment of benign gallbladder diseases, whereas robotic cholecystectomy represents a technological alternative that offers advantages such as three-dimensional visualization, greater precision of movements, and improved surgeon ergonomics. This systematic review aimed to compare both techniques regarding complications, perioperative outcomes, and cost-effectiveness. A search was conducted in the PubMed database, including randomized clinical trials published between 2010 and 2025, resulting in the inclusion of 11 studies after applying the eligibility criteria. The findings demonstrated that both approaches have similar safety profiles, with no significant differences in complication rates, mortality, conversion to open surgery, or length of hospital stay. Robotic surgery showed specific advantages, including reduced immediate postoperative pain in some studies, lower opioid consumption, improved ergonomics, reduced physical strain for the surgeon, and greater aesthetic satisfaction in single-site procedures. However, it was also associated with longer operative times in some studies and significantly higher costs related to the acquisition, maintenance, and use of robotic platforms. Therefore, laparoscopic cholecystectomy remains the preferred technique due to its effectiveness, safety, wide availability, and better cost-effectiveness, whereas robotic cholecystectomy is a feasible alternative in selected cases but currently lacks sufficient clinical or economic superiority to justify its routine adoption.