Single Incision Cholecystectomy Utilizing the SPIDER Surgical System: Experience of 225 Cases

Juan-Carlos Verdeja, MD, Julio C Lopez, Jr

Florida International University Herbert Wertheim College of Medicine, Baptist Health Medical Group

Introduction: This study evaluates the feasibility and safety of single incision cholecystectomy using the SPIDER® Surgical System in a large, single surgeon case series.

Methods and Procedures: The study is a retrospective evaluation of 225 single incision cholecystectomies performed by a single surgeon. The device used, the SPIDER® Surgical System, is a single incision platform with a 18mm outer diameter. The device is introduced through the umbilicus and then deploys to open up two flexible operative channels, and two rigid channels for a scope and a grasper. The procedure is then performed in the customary fashion using only those instruments introduced via the SPIDER system.

Results:
Mean +/- St. Dev Min Max
Age (yr) 47 +/- 15 17 90
OR Time (skin to skin in min.) 0:55 +/- 0:22 0:24 3:17

Female 180/255 (79%)

Added a trocar 5/225 (2.2%)
Converted to traditional lap 2/225 (0.4%)
Converted to open None

There was 1 post operative complication which was bleeding requiring reoperation to control. This was accomplished with 4-port laparoscopy.

Conclusions: The SPIDER Surgical System is a feasible and safe platform for performing cholecystectomies. The device was employed successfully to completely perform the procedure in 97.8% (220/225) of the cases without the addition of a trocar or conversion to traditional 4 port laparoscopy. All of the trocar additions and conversions occurred in the first 30 cases. The device proved effective in both acute and elective gallbladders, and the rate of complications was acceptable. The OR times are skin to skin and include the learning curve of the device, and those times were acceptable. Further study of the SPIDER System for cholecystectomy is recommended.

Session: Poster Presentation

Program Number: P502