Evidence map›Paper›PMID 40905966›Full record

ArticleSurgical endoscopy2025

The robotic era: 11-year retrospective study of cholecystectomies at a veterans affairs hospital.

Tess C Huy, Kasey Fitzsimmons, Joon Park, Mark Sawicki, Jeffrey L Sebastian, James S Tomlinson, Mark D Girgis Md

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PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tess C HuyVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Kasey FitzsimmonsDepartment of Surgery, UCLA David Geffen School of Medicine, 10833 Le Conte Ave 54-117 CHS, Los Angeles, CA, 90095-6904, USA.
Joon ParkVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Mark SawickiVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Jeffrey L SebastianVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
James S TomlinsonVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Mark D Girgis MdVeterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, CA, USA. mdgirgis@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic surgery has been proposed as an approach to mitigate open surgery, which is associated with increased morbidity and worse outcomes when compared to minimally invasive cholecystectomies. The study objective was to determine the effect on conversion rates and outcomes following the adoption of robotic surgery for benign gallbladder disease in a high-risk population.

methodsPatients ≥ 18 years of age who underwent cholecystectomy for benign gallbladder disease from January 1, 2013 to April 18, 2025 at a Veterans Affairs hospital were retrospectively identified. Primary outcome was rate of conversion to open surgery. Secondary outcomes included post-operative complications and 30-day re-admissions and emergency department visits. Outcomes were compared between surgical approach eras and between robotic and non-robotic cohorts. Univariate and multivariate analysis were performed adjusting for patient factors, surgical factors, and diagnosis.

results636 patients (median [IQR], 61 [46, 70] years; 86.0% male) underwent a cholecystectomy most commonly for acute cholecystitis (33.2% of surgical indications). 34.4% of patients underwent surgery during the pre-robotic era, 39.2% during the transition era, and 26.4% during the robotic era. Conversion rates decreased over time (14.6% pre-robotic, 4.0% transition, and 0.0% robotic era; p <  0.001). No conversions occurred during robotic cholecystectomy. Odds ratios of composite post-operative complications, 30-day readmissions, and 30-day emergency department visits by era were similar.

conclusionsFollowing adoption of robotic cholecystectomy for benign gallbladder disease, conversion to open and primary open surgery were safely eradicated. Use of robotic surgery for patients at highest risk for conversion or with severe disease should be considered.

Indexed as

CholecystectomyGallbladder DiseasesRobotic Surgical ProceduresAgedConversion to Open SurgeryFemaleHospitals, VeteransHumansMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsRetrospective StudiesUnited StatesAcute cholecystitisMinimally invasive acute care surgeryRobotic acute care surgeryRobotic cholecystectomyRobotic cholecystectomy conversionVeterans Affairs Hospital

Identifiers

PMID40905966
PMCPMC12618365

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.