The emerging role for robotics in cholecystectomy: the dawn of a new era?

Zaman, Jessica A.; Singh, Tejender Paul

doi:10.21037/hbsn.2017.03.01

Cited by 26 publications

(15 citation statements)

References 40 publications

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“…The role for RC in cirrhotic patients is not well defined, as evident by the paucity of the literature on this topic. [9][10][11] However, a recent publication from Strosberg et al 12 demonstrated that RC had significantly lower rates of conversion to an open procedure, which is in alignment with the data presented in the present study. They also concluded that RC seemed to be a safe and feasible procedure, although more costly in comparison with LC.…”

Section: Discussionsupporting

confidence: 90%

“…This is well documented in the literature. [7][8][9]11 Similarly, Dolejs et al 5 demonstrated that patients undergoing OC had higher rates of mortality and morbidity across all MELD scores than those undergoing LC. It is likely that this is amplified in patients with higher MELDs, and thus explains the higher rate of postoperative complications observed in these patients in our study.…”

Section: Discussionmentioning

confidence: 99%

“…16 There are studies that have shown MELD score to be a better predictor of outcomes in these patients than Child-Pugh scores. 9…”

Section: Discussionmentioning

confidence: 99%

“…RC has not gained widespread acceptance in part because of the potential for increased operative time and higher cost, with no clear advantage over LC in terms of clinical outcomes. 9 Given the potential advantages of a robotic approach to cholecystectomy, the aim of this study was to study the outcomes of RC in patients with advanced liver disease.…”

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confidence: 99%

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A Potential Role for Robotic Cholecystectomy in Patients with Advanced Liver Disease: Analysis of the NSQIP Database

Aziz

Zeeshan

Kaur

et al. 2020

The American Surgeon™

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Robotic surgery has been widely adopted by many specialties, including hepatobiliary surgery. However, robotic procedures generally require longer operative times and are costlier than their laparoscopic counterparts. The role for robotic cholecystectomy (RC), particularly in patients with advanced liver disease, has not been established. A retrospective analysis of the NSQIP database was performed, focusing on patients with chronic liver disease who underwent cholecystectomy. Patients were categorized based on their model for end-stage liver disease (MELD) score and the type of surgical procedure: open, laparoscopic, or RC. Rates of a variety of postoperative complications including length of stay (LOS) were analyzed. In patients with a MELD score of 21 to 30, open cholecystectomy was associated with a long hospital LOS (3 vs 1 vs 1; P 20.01). RC was equivalent to laparoscopic cholecystectomy in terms of perioperative mortality for higher MELD score patients but was associated with lower conversion rates and overall LOS. This data suggests that RC should be considered in patients with advanced liver disease needing cholecystectomy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

“…16 There are studies that have shown MELD score to be a better predictor of outcomes in these patients than Child-Pugh scores. 9…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Potential Role for Robotic Cholecystectomy in Patients with Advanced Liver Disease: Analysis of the NSQIP Database

Aziz

Zeeshan

Kaur

et al. 2020

The American Surgeon™

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“…Advanced simulation technology for robotic surgery and new single-site robotic platforms have the potential to further revolutionise this technology and lead to a better patient satisfaction. [ 24 ] Robotic single-port cholecystectomy is feasible but hindered by technical challenges due to the inadequate length of non-wristed robotic instruments as well as cost. On the other hand, high incidence of gallbladder rupture and trocar-site hernias may limit its application.…”

Section: Discussionmentioning

confidence: 99%

Single-incision versus four-port laparoscopic cholecystectomy in an ambulatory surgery setting

Subirana

Rey

Barri

et al. 2021

Journal of Minimal Access Surgery

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Background: Single-incision laparoscopic cholecystectomy (SILC) can be done as a day-case procedure and may have advantages over conventional laparoscopic cholecystectomy (LC). We present the results of our study looking at post-operative pain and post-operative recovery time. Methods: This was a single-institution randomised double-blind controlled trial. Seventy-three patients with symptomatic cholelithiasis were randomized to SILC ( n = 37) or LC ( n = 36). The primary endpoint was to compare post-operative pain. We also compared surgical time, procedural difficulty, adverse events, additional ports used and conversion rate, success of day surgery process, return to work, aesthetic satisfaction, quality of life and 4-year incisional hernia rate. Results: In the SILC group, post-operative analgesic requirements were lower on day 7, there was an earlier return to work and cosmetic satisfaction was significantly higher. The SILC procedure presented a higher technical difficulty. Operative time, surgical complications, post-operative pain, success of the day-case process, return to normal activity, quality of life scores and incisional hernia rates were similar for both the procedures. Conclusions: SILC has advantages over LC in terms of late post-operative analgesic requirements and aesthetic results; however, it is technically harder to perform. There was no benefit in terms of day surgery outcomes.

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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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The emerging role for robotics in cholecystectomy: the dawn of a new era?

Cited by 26 publications

References 40 publications

A Potential Role for Robotic Cholecystectomy in Patients with Advanced Liver Disease: Analysis of the NSQIP Database

A Potential Role for Robotic Cholecystectomy in Patients with Advanced Liver Disease: Analysis of the NSQIP Database

Single-incision versus four-port laparoscopic cholecystectomy in an ambulatory surgery setting

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

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