A single surgeon’s experience of single site robotic cholecystectomy : The timeline of progress

Shahida Bibi, MD, Jasna Coralic, FACS, Mohmed Bayoumi, MD, Jubin Khorsand, FACS, Leela M Prasad, FACS, FASCRS. Advocate Lutheran General Hospital Park Ridge Illinois.

Background: Use of single-site robotic cholecystectomy can overcome the limitations of single-site laparoscopic cholecystectomy. We analyze the first 102 cases of single-site robotic cholecystectomy performed by a single surgeon. 

Methods: A retrospective review of a prospectively maintained database was performed on the first 102 cases of single-site robotic cholecystectomy. Preoperative data, length of stay, conversion rate, complications, robot docking time, robotic dissection time, and overall surgery time were collected. Patients were divided into five chronological groups based on the date of surgery, with 20 patients in each group except the 5th group which had 22 patients. The groups were compared by docking time, robotic dissection time, and overall surgery time. A P value of 0.05 was used as statistically significant.

Results: The female to male ratio was 2:1. The mean age was 51 years (18-87) and the mean BMI was 28 (18-41). Overall, 69% of the patients underwent elective cholecystectomy and 31% required urgent surgery. The groups were comparable for perioperative data. The overall conversion rate was 4.9% and the complication rate was 4%. The docking time, robotic time, and average operative time were significantly different in the first group as compared to the remaining the five groups (P=0.000). Further analysis of the above variables for groups 2 through 5 did not differ statistically.

Conclusion: Single-site robotic cholecystectomy is safe and feasible in both elective and urgent conditions, and in patients with previous abdominal surgeries. It requires a short learning curve and has the benefits of minimally invasive surgery.

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