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A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases

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Abstract

Background

Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC).

Methods

Medical records of consecutive patients who underwent SIRC were retrospectively reviewed. All procedures were performed by six surgeons at five different North American centers involved in the study. All patients included in the study underwent a cholecystectomy attempted through single site at the umbilicus, using the da Vinci® Surgical System (Intuitive Surgical Inc. Sunnyvale, CA).

Results

A total of 465 patients met study criteria. Median age was 48 years (range 18–89); 351 (75.5 %) were female and 304 (66.4 %) were overweight or obese. Except for gender, case characteristics differed significantly by surgeon/site. Previous abdominal surgery was reported for 226 (48.6 %) cases. SIRC was successfully completed in 455 (97.8 %) cases, and there were no conversions to open surgery. Median surgical time was 52 min with a decreasing trend after 55–85 cases. Male gender, obesity and diagnoses other than biliary dyskinesia were independent predictors of longer surgical times. The complication rate was 2.6 %.

Conclusions

Our large, multicenter study demonstrates that robotic single-site cholecystectomy is safe and feasible in a wide range of patients.

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Acknowledgments

The authors would like to acknowledge Amy Garner (APRN-ACNP) and Michael McIntosh for data collection.

Funding

This investigator initiated study was funded as a Research Grant by Intuitive Surgical. The study was conceptualized, designed and managed by Dr. Anthony Gonzalez as a lead investigator.

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Authors and Affiliations

  1. Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA

    Anthony Gonzalez, Christian Hernandez Murcia, Rey Romero, Ernesto Escobar, Pedro Garcia & Jorge Rabaza

  2. Population Health and Outcomes Research, Center for Research & Grants, Baptist Health South Florida, Miami, FL, USA

    Gail Walker, Michelle Gallas & Don Parris

  3. Utica Park Clinic, Tulsa, OK, USA

    Eugene Dickens

  4. Premier Surgical Specialists and William Beaumont Hospital, Troy, MI, USA

    Bruce McIntosh

  5. Norwood Surgical Specialists, Shreveport, LA, USA

    William Norwood

  6. Florida Hospitals, Celebration Health, Celebration, FL, USA

    Keith Kim

Authors
  1. Anthony Gonzalez
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  2. Christian Hernandez Murcia
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  3. Rey Romero
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  4. Ernesto Escobar
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  5. Pedro Garcia
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  6. Gail Walker
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  7. Michelle Gallas
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  8. Eugene Dickens
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  9. Bruce McIntosh
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  10. William Norwood
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  11. Keith Kim
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  12. Jorge Rabaza
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  13. Don Parris
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Corresponding author

Correspondence to Anthony Gonzalez.

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Disclosures

William Norwood, MD, Christian Hernandez Murcia, MD, Rey Romero, MD, Ernesto Escobar, MD, Pedro Garcia, MD, Gail Walker, Ph.D., Michelle Gallas, Ph.D., and Don Parris, Ph.D. have no conflicts of interest or financial ties to disclose, other than the Grant received from Intuitive Surgical by their respective Institutions for this study. Anthony Gonzalez, MD is a consultant and has received research grants from Intuitive Surgical. He is a consultant with Ethicon. He is on the speaker bureau of Mallinkrodt Pharmaceuticals. He has also received research grants and participated in the scientific advisory board for Minimally Invasive Devices, Inc. Eugene Dickens, MD is a consultant for Intuitive Surgical. Bruce McIntosh, MD is a consultant for Intuitive Surgical and a speaker for Bard. Keith Kim, MD serves as consultant for Intuitive Surgical and Ethicon Endosurgery. Additionally, he has a research Grant with Ethicon Endosurgery. Jorge Rabaza, MD is a proctor for Intuitive Surgical.

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Gonzalez, A., Murcia, C.H., Romero, R. et al. A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases. Surg Endosc 30, 2951–2960 (2016). https://doi.org/10.1007/s00464-015-4583-1

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  • DOI: https://doi.org/10.1007/s00464-015-4583-1

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