EVOLUTION OF CHOLECYSTECTOMY: FROM OPEN SURGERY TO ROBOTIC APPROACH

Abstract

Cholecystectomy, the surgical procedure for gallbladder removal, represents a milestone in the evolution of surgical techniques, transitioning from traditional open surgery to minimally invasive methods such as laparoscopy and, more recently, robotic surgery. This article provides a comprehensive review of this progression, highlighting technological advancements, benefits, and limitations of each technique, based on studies published over the last five years. Introduced in the 1990s, laparoscopy has become the gold standard due to shorter recovery times, reduced postoperative pain, and fewer complications. However, robotic surgery has emerged as an innovative alternative, offering greater precision, improved ergonomics for surgeons, and three- dimensional visualization—particularly beneficial in complex cases such as obese patients or those with challenging anatomy. Despite these advantages, challenges like high costs, steep learning curves, and the need for specialized infrastructure limit its widespread adoption. This literature review, based on sources including PubMed, SciELO, and MEDLINE, critically analyzes the efficacy, safety, and cost-effectiveness of these approaches. Findings indicate that while laparoscopy remains the most accessible and widely used technique, robotics shows potential to revolutionize the field, especially in high-complexity scenarios. Additionally, the emerging role of technologies such as artificial intelligence and miniaturized instruments— which promise to further optimize surgical outcomes—is discussed. Therefore, the choice of technique should consider factors such as resource availability, surgical team expertise, and patient-specific characteristics. This underscores the importance of investments in training and future research to establish robotics as a viable large-scale surgical tool.