Abstract
Background
The aim of this work was to study the feasibility, safety, and efficacy of single-incision robotic cholecystectomy using a novel platform from Intuitive Surgical.
Methods
All operations were performed by the same surgeon. Parameters assessed included patient history, indication for surgery, operation time, complication rate, conversion rate, robot-related issues, length of hospital stay, postoperative pain, and time to return to work. All patients were followed for a 2-month period postoperatively.
Results
Forty-five patients (22 women, 23 men) underwent single-incision robotic cholecystectomy from March 1 to July 15, 2011. There were no conversions to either conventional laparoscopy or laparotomy, although in three cases a second trocar was used. There were no major complications apart from a single case of postoperative hemorrhage. Average patient age was 47 ± 12 years (range = 27–80 years) and average BMI was 30 kg/m2 (mean = 28.8 ± 4 kg/m2, range = 18.4–46.7 kg/m2). The primary indication for surgery was gallstones. The mean operation time (skin-to-skin) was 84.5 ± 25.5 min (range = 51–175 min), docking time was 5.8 ± 1.5 min (range = 4–11 min), and console time (net surgical time) was 43 ± 21.9 min (range = 21–121 min). Intraoperative blood loss was negligible. There were no collisions between the robotic arms and no other robot-related problems. Average postoperative length of stay was less than 24 h. The mean Visual Analog Pain Scale Score 6 h after the operation was 2.2 ± 1.51 (range = 0–6) and patients returned to normal activities in 4.48 ± 2.3 days (range = 1–9 days).
Conclusions
Single-Site® is a new platform offering a potentially more stable and reliable environment to perform single-port cholecystectomy. Both simple and complicated cholecystectomies can be performed with safety. The technique is possible in patients with a high BMI. The induction of pneumoperitoneum using the new port and the docking process require additional training.
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Disclosure
Konstantinos M. Konstantinidis, Petros Hirides, Savas Hirides, Pericles Chrysocheris, and Michael Georgiou have no conflicts of interest or financial ties to disclose.
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Konstantinidis, K.M., Hirides, P., Hirides, S. et al. Cholecystectomy using a novel Single-Site® robotic platform: early experience from 45 consecutive cases. Surg Endosc 26, 2687–2694 (2012). https://doi.org/10.1007/s00464-012-2227-2
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DOI: https://doi.org/10.1007/s00464-012-2227-2