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Incisional hernia after robotic single-site cholecystectomy: a pilot study

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Abstract

Purpose

Robotic LaparoEndoscopic Single-Site Surgery Cholecystectomy has been performed for 5 years using a dedicated platform (da Vinci® Single-Site®) with the da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA). While short-term feasibility has been described, long-term assessment of this method is currently outstanding. The aim of this study was to assess long-term parietal complications of this technique.

Methods

In this retrospective study, patients operated between 2011 and 2013 were evaluated. Parietal incision was assessed with ultrasonography and patients screened for residual pain from scar tissue. Demographic and perioperative data were also collected.

Results

We evaluated 48 patients [38 female, 79.2%; median age 49 years (range: 24–81 years)]; mean BMI 25.9 kg/m2 [±SD 4.1 kg/m2]. After a median follow-up of 39 months (range: 25–46 months), six incisional hernias (two patients had a positive echography but a negative clinical examination) were found (12.5%, 95% CI 7.5–30.2), and two patients had a surgical repair. The overall rate of incisional hernia was 16.7% (95% CI 7.5–30.2). Residual pain was observed in 5 of 48 patients.

Conclusion

This preliminary study suggests that a clinically significant rate of incisional hernias can occur after R-LESS-C. Larger studies comparing R-LESS-C to alternative methods with long-term follow-up are necessary.

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Abbreviations

LESS:

Laparoendoscopic single-site surgery

LESS-C:

Laparoendoscopic single-site surgery cholecystectomy

R-LESS:

Robotic laparoendoscopic single-site surgery

R-LESS-C:

Robotic laparoendoscopic single-site surgery cholecystectomy

ML-C:

Multiport laparoscopic cholecystectomy

BMI:

Body mass index

TOT:

Total operative time

COPD:

Chronic obstructive pulmonary disease

ASA:

American society of anesthesiologists

CAD:

Coronary artery disease

SD:

Standard deviation

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Acknowledgement

We would like to thank Christophe Combescure for statistical support.

Authors contributions

AB, NCB, SPN, LHB, and PM designed the project. AB, AZ, and GV acquired the echography data. AB, AZ, and MKJ acquired the clinical data. AB, NCB, SPN, MEH, AZ, MKJ, GV, LHB, and PM contributed to the writing of the manuscript and its critical revision. AB, NCB, SPN, MEH, AZ, MKJ, GV, LHB, and PM approved the final version.

Author information

Authors and Affiliations

  1. Division of Digestive and Transplantation Surgery, University Hospitals Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland

    A. Balaphas, N. C. Buchs, S. P. Naiken, M. E. Hagen, A. Zawodnik, M. K. Jung, L. H. Bühler & P. Morel

  2. Division of Radiology, University Hospitals Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland

    G. Varnay

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  1. A. Balaphas
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  2. N. C. Buchs
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  3. S. P. Naiken
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  4. M. E. Hagen
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  5. A. Zawodnik
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  6. M. K. Jung
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  7. G. Varnay
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  8. L. H. Bühler
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  9. P. Morel
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Corresponding author

Correspondence to A. Balaphas.

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Conflict of interest

AB declares no conflict of interest. MH declares conflict of interest not directly related to the submitted work. NB declares no conflict of interest. SN declares no conflict of interest. AZ declares no conflict of interest. MJ declares no conflict of interest. LB declares no conflict of interest. GV declares no conflict of interest. PM declares no conflict of interest.

Ethical approval

Diagnostic procedures were in accordance with the ethical standards of the national research committee and the 1964 Helsinki declaration and its later amendments.

Human and animal rights

This study was approved by our institutional review board and national research committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Balaphas, A., Buchs, N.C., Naiken, S.P. et al. Incisional hernia after robotic single-site cholecystectomy: a pilot study. Hernia 21, 697–703 (2017). https://doi.org/10.1007/s10029-017-1621-z

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  • DOI: https://doi.org/10.1007/s10029-017-1621-z

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