Study compares robotic, laparoscopic cholecystectomy cost drivers

Editor's Note

A retrospective review of 14 hospitals over 7 years found that robotic cholecystectomy costs were, on average, 2.5 times higher than laparoscopic cholecystectomy ($1,447 vs. $669 per case). Findings were published on March 19 in the journal Surgery. Disposable instrument choices also impact costs.

Despite the rising adoption of robotic procedures—climbing from 0.1% of cases in 2017 to 26% in 2024—no meaningful differences were observed in OR time, readmission rates, length of stay, or 30-day reintervention rates between robotic and laparoscopic approaches, the researchers wrote. However, robotic cholecystectomy was associated with a significantly lower conversion rate, at an estimated cost of $93,000 per conversion prevented.

Surgeons' individual choices in disposable equipment further amplified cost discrepancies. Among laparoscopic procedures, the cheapest surgeon’s average disposable cost was $272, while the most expensive reached $1,934. Similar variation was seen in robotic cases. Standardizing disposable equipment use to the 25th percentile of costs could yield potential savings of 35% for laparoscopic cholecystectomy and 24% for robotic procedures.