The patient had gall bladder inflammation caused by stones and a blocked duct, increasing the risk of bile duct injury

RG Hospitals Pitampura has successfully managed a complex case of calculus cholecystitis (a condition where gall bladder inflammation is caused by gallstones), involving an impacted cystic duct stone using robotic-assisted surgery. The procedure was performed by Dr. Manish D Sharma, Head of the Department of Minimal Access, General, Robotic & Bariatric Surgery. The patient, a 30-year-old woman, presented with persistent right upper abdominal pain, vomiting sensations, and post-meal heaviness, and was diagnosed with a surgically challenging gall bladder condition requiring advanced intervention.

Calculus cholecystitis with an impacted cystic duct stone is recognised as a technically demanding condition due to distorted anatomy and an increased risk of bile duct injury. In this case, clinical evaluation revealed a thick-walled, distended gall bladder with multiple gallstones measuring between 3 and 12 mm, biliary sludge, and dense adhesions with the omentum, while the common bile duct remained normal. Such findings often complicate conventional surgical approaches, making precise dissection critical to ensure patient safety.

Commenting on the case, Dr. Manish D Sharma said, “Impacted cystic duct stones significantly distort normal anatomy and increase surgical risk. Robotic-assisted surgery provides enhanced three-dimensional visualisation and precise instrument control, allowing safe dissection and optimal outcomes even in complex biliary cases.”

The patient underwent a robotic-assisted cholecystectomy under general anaesthesia. During the procedure, dense adhesions between the gall bladder and omentum were carefully managed, and robotic precision enabled the accurate dissection of Calot’s triangle while preserving the cystic artery and common bile duct. The surgery was completed successfully without any intraoperative complications, demonstrating how robotic technology can reduce tissue trauma and enhance safety in technically demanding gall bladder surgeries.

The case highlights the expanding role of robotic-assisted surgery in managing complex gall bladder conditions, particularly where distorted anatomy increases surgical risk. With the use of precise visualisation and controlled dissection, the procedure enabled a safe outcome in a technically demanding case, reflecting the growing application of robotic techniques in biliary surgery at RG Hospitals Pitampura.