Single-Site Robotic Cholecystectomy: Initial Experience

Subhashini Ayloo, MD, FACS, Nabajit Choudhury. Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.

Aim: Recently single-site robotic platform has been introduced to alleviate some of the technical challenges with laparoscopic single site surgery. We present a single institution single surgeon’s experience with the single-site robotic cholecystectomies since FDA approval.

Methods: From February 2012 to 2013, 31 patients underwent robotic single-site cholecystectomies at a tertiary care facility. Patient’s demographics, intraoperative and postoperative outcomes were analyzed retrospectively from a prospectively maintained database. No exclusion criteria were used.

Results: 25 women and 6 men with mean age, Body Mass Index (BMI) and weight of 33.64years, 32.20 kg/m2, 86.33 kg respectively for symptomatic cholelithiasis. 11 patients (35.48%) had previous abdominal surgeries. The mean operative time was 81.48 ± 21.07 minutes with average time for port insertion, docking, console, fascia/skin closure of 12.03 ± 4.81, 5.29 ± 5.96, 36 ± 16.75, and 24.64-± 6.78 minutes respectively. The average EBL was 8.38 ± 4.16 ml. Twenty-four (77.41%) procedures were performed on an outpatient basis. There were no conversions to the open or multiport approach, and no major complications of biliary ductal injury, bile leak, reoperations, or mortality occurred. There was one case of superficial wound infection treated with oral antibiotics.

Conclusion: Single-site robotic cholecystectomy is feasible, safe with good outcomes and requires a minimal learning curve to transition from traditional multiport to single-port robotic cholecystectomy.

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