Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

Abstract

Backgrounds/Aims: Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. However, as a result of the ongoing trend toward minimally invasive laparoscopy, single-incision laparoscopic cholecystectomy (SILC) has evolved. Single-incision robotic cholecystectomy (SIRC) can overcome several limitations of manual SILC. The purpose of this study is to evaluate and compare the safety and feasibility of SIRC and SILC. Methods: This study retrospectively reviewed data for all patients who underwent SIRC or SILC from March 2018 to July 2019 in a single institution. The following variables were analyzed: age, sex, body mass index, pain scale, length of stay, and complications. The data were analyzed using the Independent two sample t-test or the Fisher's exact test. Results: A total of 343 patients underwent SIRC or SILC during the study period. After excluding patients with acute cholecystitis, 197 SIRC and 103 SILC patients were analyzed in this study. The surgery time and postoperative hospital stay did not differ between SIRC and SILC. However, the SIRC patients experienced less bile spillage during the surgery than did the SILC patients (SIRC vs. SILC: 24 (23.3%) vs. 11 (5.6%) cases, respectively; p＜0.001). Although there was no difference in the incidence of postoperative complications between procedures, additional pain control was administered more frequently in SILC patients (SILC 1.08±0.893, SIRC 0.58±0.795; p＜0.001). Conclusions: While both SILC and SIRC are effective for single-incision cholecystectomy, SIRC was superior to SILC in terms of technical stability. Moreover, it has the advantage of postoperative pain control.

Propensity Score Matched Comparison of Robotic Single-Site and Laparoscopic Cholecystectomy

“…As RSSC has emerged as a major method cholecystectomy, previous studies have confirmed its efficacy compared with other surgical methods. 4,6,[12][13][14][15][16][17] In most studies, compared with CLC and SILC, RSSC showed similar results in terms of surgical outcomes while maximizing the advantages of single-incision surgery, demonstrating its safety and feasibility.…”

“…10 After PSM, the only statistically significant difference between CLC and RSSC was operative times: 29. 15 Although the open conversion rate and complications could not be statistically proven after PSM, there seemed to be no significant difference between the two groups, even before PSM (Table 2). No additional ports were used in either group.…”

Single‐site robotic cholecystectomy versus single‐incision laparoscopic cholecystectomy: A systematic review and meta‐analysis

“…The exclusion was due to several reasons, including not having control groups, multiport laparoscopic, and pediatric populations. Hence, a final 13 studies (of 817 and 757 patients who underwent SSRC and SILC) were included for quantitative synthesis 13–25 . One study was a single‐blind RCT, nine were retrospective cohorts, and the remaining three were prospective cohort studies.…”

“…Hence, a final 13 studies (of 817 and 757 patients who underwent SSRC and SILC) were included for quantitative synthesis. [13][14][15][16][17][18][19][20][21][22][23][24][25] One study was a single-blind RCT, nine were retrospective cohorts, and the remaining three were prospective cohort studies. The data characteristics are available in Table 1.…”

Can a single-port robot be safely used for robotic total gastrectomy for advanced gastric cancer? First experience using the da Vinci SP platform

“…For SP surgery, the SP robotic platform is more stable to operate than the SP laparoscope that is currently in common use [ 3 ]. Additionally, the snake-shaped robotic arm can effectively avoid the “chopstick effect,” reducing the number of surgical instrument collisions and the frequency of requiring additional ports to complete the surgery [ 4 ].…”