Single-incision Robotic Cholecystectomy: Initial Experience and Results

Abstract

Purpose: Continued efforts to reduce the invasiveness of conventional cholecystectomy techniques have resulted in the development of single-incision cholecystectomy. However, a single-port approach has significant limitations associated with proper triangulation and instrument crowding and collisions. Although the da Vinci Single-Site robotic system has been proposed to overcome these problems, objective evidence of the feasibility and ergonomics of single-incision robotic cholecystectomy (SIRC) is insufficient. Therefore, the present study aimed to evaluate the feasibility and efficacy of SIRC by using objective data obtained from consecutive patients who underwent surgery with the single-incision robotic platform performed by a single surgeon. Methods: Forty patients who underwent SIRC between August 2014 and December 2015 wereidentified. Demographic, perioperative, and postoperative data were collected retrospectively. Results:The mean docking time was 10.82±4.85 min (range, 4~30 min). The mean console time was 49.63±10.82 min (range, 24~90 min). None of the patients required an additional laparoscopic arm, an additional robotic arm, or conversion to conventional laparoscopic cholecystectomy. Conclusion:SIRC can provide a safe operative procedure, good operative results, and high patient satisfaction, and cause less surgeon fatigue. Therefore, our study results indicate that SIRC is feasible and favorable for both patients and physicians.

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

“…RSSC, on the other hand, has overcome the shortcomings of SILC, such as narrowing of the working space, improper triangulation, collision between laparoscopic instruments, and challenges in delicate movement by maximizing the advantage of single incision surgery. 2,5,[7][8][9] In the present study, RSSC was conducted for three years, and it was during this period that the early experience of RSSC 10 was compared to the results of CLC. Furthermore, to eliminate the bias of the RSSC as an initial experience, the learning curve was determined.…”