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Klein J, Lemma M, Prabhakaran K, et al. . Trauma Surg Acute Care Open. 2024;9:e001522.

Hawley KL, Nagaraj M, Marshall WA. . Trauma Surg Acute Care Open. 2025; in press.

Klein and coauthors conducted a retrospective study of data from a single institution over a 3-year interval (n = 260) to compare operative times in patients undergoing laparoscopic or robotic cholecystectomy. Patients were classified according to severity as mild (A), moderate (B), severe (C), or extreme (D) cholecystitis using an accepted grading system.

The data showed that patients undergoing robotic cholecystectomy had significantly shorter operative times for patients with class B or C cholecystitis. The conversion rate to open cholecystectomy was similar in both groups.

The authors concluded that robotic cholecystectomy had the advantage of shorter operative time in classes B and C cholecystitis. Use of robotic techniques could benefit these patient groups.

In the editorial that accompanied the article, Hawley and coauthors noted that categorizing patients using this grading scale could assist surgeons in selecting patients for robotic cholecystectomy.

While there is agreement that these data suggest potential patient benefit associated with use of grading systems to guide choice of laparoscopic versus robotic cholecystectomy, other factors such as patient satisfaction, quality of life, and healthcare costs are also worth considering.