Conference Coverage

Robotic and Laparoscopic Cholecystectomies Show Comparable Opioid Use in Perioperative Care

Kate Young

Key Highlights

  • No significant difference was found in perioperative opioid administration between laparoscopic and robotic cholecystectomies.
  • Operative time did not influence opioid usage between surgical modalities.
  • Both approaches demonstrated similar intraoperative and PACU opioid requirements.
  • Findings support further research into robotic surgery’s broader impact on perioperative opioid use.

A study conducted by Melissa Torbey, MHA, and colleagues found no statistically significant differences in perioperative opioid administration between robotic and laparoscopic cholecystectomies. These findings were presented at the ANESTHESIOLOGY annual meeting. Intraoperative and postoperative (PACU) opioid requirements were comparable, suggesting that the choice of minimally invasive technique—laparoscopic versus robotic—does not significantly influence opioid needs during or after surgery. Operative times were also similar, indicating that this factor did not confound the findings.

The investigation was driven by the ongoing opioid epidemic, a major public health concern in the United States, where the vast majority of surgical patients receive opioids for perioperative pain control. While laparoscopic surgery has been shown to reduce opioid use and hasten recovery compared with open surgery, there has been limited evidence evaluating how the increasingly popular robotic approach compares to laparoscopy in this regard. This study sought to fill that gap.

Researchers conducted a retrospective review of 39 elective cholecystectomies (20 laparoscopic and 19 robotic) performed by a single surgeon at one outpatient surgical center. Perioperative opioid administration was measured in morphine milligram equivalents (MME) during both intraoperative and PACU periods. Operative time was assessed as a potential confounding variable. Given non-normal data distribution, statistical analysis was performed using the Wilcoxon rank-sum test with Hodges-Lehmann comparisons.

Results demonstrated mean intraoperative opioid use of 14.3±6.6 MME for laparoscopic cases versus 13.9±7.8 MME for robotic cases (P = .7184). Postoperatively, PACU opioid use was 12.1±6.9 MME for laparoscopic and 13.1±9.3 MME for robotic procedures (P = .9546). Operative times were similar between the two groups—142.8±74.6 minutes for laparoscopic and 115.7±29.7 minutes for robotic surgeries (P = .2982)—confirming that operative duration did not affect opioid administration outcomes.

“Our preliminary finding reveals there is no statistical difference in opioid administration intraoperatively and in PACU when comparing elective robotic and laparoscopic cholecystectomies,” Torbey and colleagues concluded. “Additionally, operative time did not significantly impact the perioperative opioid administration between surgical modalities.”

Reference:
Torbey M, Caldwell T, Irazoqui Ruiz YI, Zhu J. The impact of surgical modality on perioperative opioid management. Presented at: Anesthesiology Annual Meeting; October 10–14, 2025; San Antonio, TX. https://www.asahq.org/annualmeeting/attend.