COMPARISON OF ERAS PATHWAY COMPLIANCE AND OUTCOMES IN ROBOTIC VS LAPAROSCOPIC CHOLECYSTECTOMY. poojadutta58@yahoo.com

 

COMPARISON OF ERAS PATHWAY COMPLIANCE AND OUTCOMES IN ROBOTIC VS LAPAROSCOPIC CHOLECYSTECTOMY.

1

India

Oral only

Enhanced Recovery After Surgery (ERAS) protocols are increasingly incorporated into minimally invasive biliary surgery, aiming to reduce postoperative morbidity and enhance functional recovery. While robotic cholecystectomy (RC) offers improved ergonomics and precision, its impact on ERAS pathway compliance and postoperative outcomes compared with laparoscopic cholecystectomy (LC) remains insufficiently defined.

This prospective observational study included adult patients undergoing elective cholecystectomy under a standardized ERAS protocol. Patients were grouped into RC and LC cohorts. ERAS compliance was assessed across preoperative, intraoperative, and postoperative components. Primary outcomes included total ERAS adherence score and length of hospital stay. Secondary outcomes included postoperative pain scores, opioid consumption, time to oral intake, ambulation time, complication rates (Clavien–Dindo), and 30-day readmissions.

A total of 100 patients were included (RC = 45; LC = 55). Overall ERAS compliance was significantly higher in the robotic group, mainly due to better adherence to intraoperative components such as normothermia maintenance and minimal opioid use. Patients undergoing RC demonstrated lower postoperative pain scores at 6 and 24 hours and required fewer opioids. Time to ambulation and oral intake was shorter in the RC group, contributing to a reduced mean length of stay. Complication and readmission rates were comparable between groups.

Robotic cholecystectomy is associated with higher ERAS pathway compliance and improved early postoperative recovery compared with laparoscopy, without increasing complication rates. These findings support the integration of robotic techniques into ERAS-driven biliary surgery, particularly for centers aiming to optimize recovery metrics.