Abstract
Aim
To investigate the learning curve and perioperative outcomes of single-site robotic cholecystectomy during the first 102 cases by a single surgeon.
Materials and methods
A retrospective review of a prospectively maintained database was performed on the first 102 cases of single-site robotic cholecystectomy. 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 28.26 (18–41). Overall, 69 % of the patients underwent elective cholecystectomy and 31 % required urgent surgery. In all, 17 % of patients had previous abdominal surgeries. In total, 45 % of procedures were regarded as same day surgery. The total mean length of stay was 1.97 days (0–8). The mean operative time was 110 min (36–265), mean robotic console time 70 min (26–179), and mean docking time 9 min (1–26). The overall conversion rate was 3.9 % 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 = 0.001).
Conclusion
Single-site robotic cholecystectomy is safe in both elective and urgent conditions, and in patients with previous abdominal surgeries. It has a short learning curve.
Similar content being viewed by others
References
Curcillo PG, Wu AS, Podolsky ER, Graybeal C, Katkhouda N, Saenz A et al (2010) Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc 24:1854–1860
Roberts KE, Solomon D, Duffy AJ, Bell RL (2010) Single-incision laparoscopic cholecystectomy: a surgeon’s initial experience with 56 consecutive cases and a review of the literature. J Gastrointest Surg 14:506–510
Mutter D, Callari C, Diana M, Dallemagne B, Leroy J, Marescaux J (2001) Single port laparoscopic cholecystectomy: which technique, which surgeon, for which patient? A study of the implementation in a teaching hospital. J Hepatobiliary Pancreat Sci 18:453–457
Prasad A, Mukherjee KA, Kaul S, Kaur M (2011) Postoperative pain after cholecystectomy: conventional laparoscopy versus single-incision laparoscopic surgery. J Minim Access Surg 7:24–27
Wren SM, Curet MJ (2011) Single-port robotic cholecystectomy: results from a first human use clinical study of the new da Vinci single-site surgical platform. Arch Surg 146:1122–1127
Allemann P, Leroy J, Asakuma M, Al Abeidi F, Dallemagne B, Marescaux J (2010) Robotics may overcome technical limitations of single-trocar surgery: an experimental prospective study of Nissen fundoplication. Arch Surg 145:267–271
Seo IY, Rim JS (2011) Bilateral robotic single-site partial nephrectomy. J Laparoendosc Adv Surg Tech A 21:435–438
Pietrabissa A, Sbrana F, Morelli L, Badessi F, Pugliese L, Vinci A, Klersy C, Spinoglio G (2012) Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology. Arch Surg 147(8):709–714
Spinoglio G, Lenti LM, Maglione V, Lucido FS, Priora F, Bianchi PP, Grosso F, Quarati R (2012) Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience. Surg Endosc 26:1648–1655
Vidovszky TJ, Carr AD, Farinholt GN, Ho HS, Smith WH, Ali MR (2014) Single-site robotic cholecystectomy in a broadly inclusive patient population: a prospective study. Ann Surg 260(1):134–141
Ayloo S, Choudhury N (2014) Single-site robotic cholecystectomy. JSLS 18(3):115-119
Pietrabissa A, Sbrana F, Morelli L, Badessi F, Pugliese L, Vinci A et al (2012) Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology. Arch Surg 147:709–714
Morel P, Hagen ME, Bucher P, Buchs NC, Pugin F (2011) Robotic single-port Cholecystectomy using a new platform: initial clinical experience. J Gastrointest Surg 15:2182–2186
Vidovszky TJ, Smith W, Ghosh J, Ali MR (2006) Robotic cholecystectomy: learning curve, advantages, and limitations. J Surg Res 136(2):172–178
Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel Single-Site® robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694
Svoboda S, Qaqish TR, Wilson A, Park H, Youssef Y (2014) Robotic single-site cholecystectomy in the obese: outcomes from a single institution. Surg Obes Relat Dis. doi:10.1016/j.soard.2014.11.016
Zhou MW, Gu XD, **ang JB, Chen ZY (2014) Comparison of clinical safety and outcomes of early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis. ScientificWorldJournal 2014:274516
Morel P, Buchs NC, Iranmanesh P, Pugin F, Buehler L, Azagury DE, Jung M, Volonte F, Hagen ME (2014) Robotic single-site cholecystectomy. J Hepatobiliary Pancreat Sci 21(1):18–25
Iranmanesh P, Morel P, Buchs NC, Pugin F, Volonte F, Kreaden US, Hagen ME (2013) Docking of the da Vinci Si Surgical System® with single-site technology. Int J Med Robot 9:12–16
Chaudhary S, Bhullar JS, Subhas G, Mittal VK, Kolachalam R (2013) Single-incision laparoscopic cholecystectomy (SILC) using non-articulating instruments and conventional trocars-single surgeon experience. J Gastrointest Surg 17(4):809–813
Angus AA, Sahi SL, McIntosh BB (2014) Learning curve and early clinical outcomes for a robotic surgery novice performing robotic single site cholecystectomy. Int J Med Robot 10(2):203–207
Turchetti G, Palla I, Pierotti F, Cuschieri A (2012) Economic evaluation of da Vinci-assisted robotic surgery: a systematic review. Surg Endosc 26:598–606
Gonzalez AM, Rabaza JR, Donkor C, Romero RJ, Kosanovic R, Verdeja JC (2013) Single-incision cholecystectomy: a comparative study of standard laparoscopic, robotic, and SPIDER platforms. Surg Endosc 27(12):4524–4531
Buzad FA, Corne LM, Brown TC, Fagin RS, Hebert AE, Kaczmarek CA, Pack AN, Payne TN (2013) Single-site robotic cholecystectomy: efficiency and cost analysis. Int J Med Robot 9(3):365–373, 365–370
Kamiński JP, Bueltmann KW, Rudnicki M (2014) Robotic versus laparoscopic cholecystectomy inpatient analysis: does the end justify the means? J Gastrointest Surg 18(12):2116–2122
Nelson EC, Gottlieb AH, Müller HG, Smith W, Ali MR, Vidovszky TJ (2014) Robotic cholecystectomy and resident education: the UC Davis experience. Int J Med Robot 10(2):218–222
Pisanu A, Reccia I, Porceddu G, Uccheddu A (2012) Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC). J Gastrointest Surg 16:1790–1801
Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P (2012) Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc 26:1205–1213
Fung AK, Aly EH (2012) Systematic review of single-incision laparoscopic colonic surgery. Br J Surg 99(10):1353–1364
Acknowledgments
We would like to thank Suela Sulo, PhD, Manager of Patient-Centered Outcomes Research, James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge IL 60068 for the help with statistics and review of the article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bibi, S., Rahnemai-Azar, A.A., Coralic, J. et al. Single-Site Robotic Cholecystectomy: The Timeline of Progress. World J Surg 39, 2386–2391 (2015). https://doi.org/10.1007/s00268-015-3135-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-015-3135-0