Surgeons should weigh the nuanced benefits and risks of robotic and laparoscopic cholecystectomy for gallstone disease.

• Robotic cholecystectomy (RC) has longer operative times, especially in Western centers (75 vs. 60 minutes).
• There’s a higher rate of bile duct injury with RC (0.72% vs. 0.23%), though early learning curves may play a role.
• RC shows reduced conversion to open surgery (odds ratio 0.44) and fewer serious complications (odds ratio 0.82).

Laparoscopic cholecystectomy remains the standard due to its effectiveness and lower costs ($2,000-$3,000 vs. RC’s $5,000-$6,000). Evaluating patient characteristics and surgeon expertise is crucial in determining the optimal approach.