ArticleSurgical endoscopy2026
Differences in utilization and outcomes for laparoscopic versus robotic cholecystectomy in patients with class IV obesity: a retrospective cohort analysis of the NSQIP database.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundAs the prevalence of class IV obesity (BMI ≥ 50) has continued to rise, the incidence of obesity-related gallstone disease and cholecystectomy in this population has also increased. Yet it remains unclear whether a robotic approach may offer selective benefits for these patients compared to traditional laparoscopic techniques. The objectives of this study are to (1) describe associations between obesity class and operative approach and (2) assess the impact of robotic approach and obesity class on perioperative outcomes.
methodsThe ACS-NSQIP database was queried from 2022 to 2023 to identify all laparoscopic and robotic cholecystectomies. Patients were stratified by obesity class. Associations between obesity class and operative approach were evaluated with multivariable logistic regression. Multivariable linear and logistic regression models examined associations between operative approach and obesity class with continuous and binary outcome measures, respectively. Sensitivity analysis was subsequently performed to adjust for postoperative biliary diagnosis.
resultsA total of 99,013 patients underwent minimally invasive cholecystectomy, with 11,951 (12%) cases performed robotically and 2403 (2.4%) with class IV obesity. Patients with class IV obesity were more likely to undergo robotic operations (21.0% vs not obese 11.0%, aOR 1.75, 95%CI 1.56-1.95). While the robotic approach was correlated with increased operative time (β = 9.6, 95%CI 8.8-10.0), it was associated with lower odds of perioperative complications compared to laparoscopic cases (2.5% vs 3.0%, aOR 0.88, 95%CI 0.77-0.99). When adjusted for postoperative diagnosis, the association between the robotic operative approach and lower perioperative complication rate was no longer statistically significant.
conclusionsPatients with class IV obesity had increased odds of undergoing robotic cholecystectomy, and while the robotic approach did not improve operative time, it was associated with decreased odds of death or serious morbidity, although this association was likely due to differences in patient selection and case mix.
Indexed as
Identifiers
42301468What OpenQuestion holds
Registered trials
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.