Learning Curve and Early Outcomes of Robotic Cholecystectomy: A Retrospective Cohort Study of the First 150 Cases at a Tertiary Care Hospital

Abstract

Objective: This study aimed to evaluate the safety and feasibility of robotic-assisted cholecystectomy using the CMR Versius system and to characterize operative performance during the initial institutional experience. Study design and setting: This retrospective cohort study took place at Surgical Unit 4, Ward 21, Jinnah Postgraduate Medical Center, Karachi, Pakistan Methodology: This retrospective analysis was conducted on the first 150 consecutive robotic cholecystectomy cases. These cases were performed by a trained surgeon between January 2024 and January 2026. Data were extracted from a prospectively maintained database. Results: Out of 150 planned procedures, the majority (n=130 robotic-assisted cholecystectomies + 6 converted to Laparoscopic and 9 combined with other procedures) were completed robotically. No bile injury was noted. The mean console time was 26 minutes. The mean setup time recorded was 15 minutes. Three cases were converted to open surgery due to complex pathology (empyema, fistula). There were two procedures in patients with advanced chronic liver disease and ascites that were abandoned. Postoperative pain reported by patients was minimal, with 82.7% patients reporting Visual Analog Scale (VAS) score of 0 on postoperative day 1. Sequential operative-time analysis demonstrated improvement during the early cases followed by relative stabilization later in the series. Conclusion: Robotic-assisted cholecystectomy using the Versius platform proved to be a safe and feasible option, even in anticipated difficult cases with minimal learning curve