Single‐incision robotic cholecystectomy is associated with a high rate of trocar‐site infection

Lim, Chetana; Nassif, Georges Bou; Lahat, Eylon; Hayek, Mohamad; Osseis, Michael; Gómez‐Gavara, Concepción; Moussalem, Toufic; Azoulay, Daniel; Salloum, Chady

doi:10.1002/rcs.1856

Cited by 12 publications

(5 citation statements)

References 24 publications

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“…Higher hernia rates after SSRC than LC can be explained by a wider incision along the linea alba to insert the single‐site port. The further enlargement of the mini‐laparotomy at the end of the procedure is probably due to excessive force of the robotic system at the incision site 16 . A wide abdominal access may be considered an advantage in case of big gallbladder stones (>1.5 cm), but at the same time it may be linked to a higher risk of hernia development.…”

Section: Discussionmentioning

confidence: 99%

Outcome after single‐site robotic cholecystectomy: An initial single center's experience

Ricciardiello

Grottola

Panaccio

et al. 2020

Asian J Endoscop Surgery

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Background Although laparoscopic cholecystectomy (LC) is the gold standard for symptomatic gallbladder disease, a single‐incision approach may be a new challenge in order to achieve minimization of surgical trauma. Single‐site robotic cholecystectomy (SSRC) is able to offset the ergonomic limitation of laparoscopic single‐site cholecystectomy and improves cosmesis. Methods We present a single‐institution initial experience of SSRC for cholecystolithiasis. Intra‐operative and post‐operative data of patients were reviewed to assess the technical feasibility and cosmetic outcome. Results We evaluated a series of 27 consecutive patients retrospectively analyzed and prospectively collected who underwent SSRC. One patient was excluded from the final analysis because they converted to open procedure. The female/male ratio was 17/9, with mean age of 48 ± 12 years. The body mass index mean value was 26.0 ± 4.2. The mean operative time was 99.6 ± 21.5 minutes. No intra‐ or post‐operative complications and readmissions were recorded. At 12 months follow up, every patient received the Body Image Questionnaire (BIQ) and a Photo Series Questionnaire. We recorded three patients (11.5%) with post‐operative incisional hernia. Scores of the BIQ subscale for body image perception were 6 ± 1.2, while the scores of scar cosmesis were 21.1 ± 3.0. A statistically significant improvement in scar self‐rating from T0 to T1 (P < .01) was found. Conclusion In our initial experience SSRC may be preferred to treat patients with higher needs in terms of cosmesis and body image perception. Lower costs for rent, maintenance and consumables may allow the spread of robotic surgery also for singe site cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Outcome after single‐site robotic cholecystectomy: An initial single center's experience

Ricciardiello

Grottola

Panaccio

et al. 2020

Asian J Endoscop Surgery

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

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

Rudiman

Hanafi

Almawijaya

2023

Annals of Gastroent Surgery

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BackgroundThe possibilities of minimally invasive cholecystectomy have emerged since the beginning of single‐incision laparoscopic cholecystectomy (SILC) and single‐site robotic cholecystectomy (SSRC). This study aimed to compare the feasibility, safety, and pain scores between SSRC and SILC.MethodsThe authors searched randomized or non‐randomized controlled trials and observational studies in PubMed, EuroPMC, and ClinicalTrials.gov from April 2012 until April 2022. The authors analyzed the operation time, hospital stay, blood loss volume, conversion rate, intraoperative complication rates, postoperative complications, visual analog scale (VAS) immediately after surgery, and VAS at hospital discharge. This study aligned with PRISMA and AMSTAR guidelines.ResultsThirteen studies were selected with 817 and 757 patients who underwent SSRC and SILC. Thus, this study demonstrated a lower incidence of intraoperative complication rates [relative risk (RR) 0.57 (95% CI 0.34–0.96), p = 0.03] and lesser VAS score at hospital discharge [Std. Mean Difference (SMD) −0.23 (95% CI −0.46, −0.01), p = 0.04] in the SSRC group. Regarding operation time and cost, SSRC revealed a longer time [SMD 1.02 (95% CI 0.45, 1.59), p = 0.0004] and higher cost [SMD 4.18 (95% CI 1.77, 6.58), p < 0.00001], respectively. Meanwhile, SSRC did not differ from SILC during a hospital stay, blood loss volume, conversion rate, postoperative complication rates, and VAS immediately after surgery.ConclusionsConcerning intraoperative complication rates and VAS score at hospital discharge, SSRC was superior to SILC. Thus, SSRC is considered a feasible and safe procedure.

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“…Minimally invasive surgery for gallbladder disease has advantages of less pain, smaller scars, shorter length of hospital stay and quicker return to normal activities, which has become increasingly popular in patients (Bignell et al 2013;Bisgaard et al 2002;Sinagra et al 2018). Although several studies have revealed the e cacy of SILC, its increased risks of pain, bile duct injury and port-site hernia formation with a larger umbilical incision and prolonged operative time, and the need for specialty ports and instruments have raised con icting concerns (Arezzo et al 2018;Hoyuela et al 2019;Lee et al 2019;Lim et al 2017). In this study, a TILC technique was described that only needs conventional instruments.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy with two mini incisions: an innovative, feasible and safe technique with superior cosmetic outcomes

Xu¹,

Wang²,

Fang³

et al. 2020

Preprint

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The conventional laparoscopic cholecystectomy (CLC) is usually performed with four incisions in a simple and safe way. Minimally invasive surgery for gallbladder disease with advantages of less pain and smaller scars, has become increasingly popular in patients. This study aimed to describe our experience in performing a new technique of two-incision laparoscopic cholecystectomy (TILC) with conventional instruments and make a comparison with CLC. In this study, forty-three prospective patients undergoing TILC and another forty-three historical cases operated by CLC were involved. The patients were examined in respect of operative time, postoperative pain, cosmesis and complications. We found that there was no significant difference in the gender, age, body mass index, bile duct damage, blood loss and days of postoperative hospital stay between TILC and CLC. The mean operation time in TILC was longer than that in CLC, but not statistically different. Significantly lower postoperative pain scores were reported in the TILC group than those in the CLC one (p = 0.019). The mean cosmetic satisfaction score was significantly higher in TILC group than that in CLC group (p < 0.05). These results confirm that TILC is a safe and feasible technique with less postoperative pain and a significant improvement in cosmesis for patients, only by using conventional instruments. It may be a good alternative to CLC in the future.

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Single‐incision robotic cholecystectomy is associated with a high rate of trocar‐site infection

Abstract: The robotic approach does not seem to offer additional benefit in terms of surgical outcomes.

Cited by 12 publications

References 24 publications

Outcome after single‐site robotic cholecystectomy: An initial single center's experience

Outcome after single‐site robotic cholecystectomy: An initial single center's experience

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

Laparoscopic cholecystectomy with two mini incisions: an innovative, feasible and safe technique with superior cosmetic outcomes

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