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Choi YJ, Sang NT, Jo HS, Kim DS, Yu YD. A single-center experience of over 300 cases of single-incision robotic cholecystectomy comparing the da Vinci SP with the Si/Xi systems. Sci Rep 2023; 13:9482. [PMID: 37301853 PMCID: PMC10257706 DOI: 10.1038/s41598-023-36055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
Minimally invasive surgery is usually more beneficial than open surgeries in various fields of surgery. With the newly developed Single-Port (SP) robotic surgical system, even single-site surgery has become easier to access. We compared single-incision robotic cholecystectomy between the Si/Xi and SP systems. This retrospective single-center study enrolled patients who underwent single-incision robotic cholecystectomy between July 2014 and July 2021. The clinical outcomes of the da Vinci Si/Xi and SP systems were compared. In total, 334 patients underwent single-incision robotic cholecystectomy (118 Si/Xi vs. 216 SP). The SP group had more chronic or acute cholecystitis than the Si/Xi group did. There was more bile spillage in the Si/Xi group during the surgery. The total operative and docking times were significantly shorter in the SP group. There was no difference in the postoperative outcomes. The SP system is safe and feasible regarding comparable postoperative complication rates and is more convenient regarding docking and techniques.
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Affiliation(s)
- Yoo Jin Choi
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Nguyen Thanh Sang
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
- Department of Surgery, Trung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Hye-Sung Jo
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Dong-Sik Kim
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea
| | - Young-Dong Yu
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea.
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Lee SJ, Moon JI, Choi IS. Robotic single-site cholecystectomy is better in reducing postoperative pain than single-incision and conventional multiport laparoscopic cholecystectomy. Surg Endosc 2023; 37:3548-3556. [PMID: 36604338 DOI: 10.1007/s00464-022-09846-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND To compare the short-term outcomes of robotic single-site cholecystectomy (RSSC) with single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC), focusing on postoperative pain outcomes. METHODS This single-center retrospective study included consecutive patients with benign gallbladder disease who underwent cholecystectomy by a single surgeon between June 2019 and December 2021. Exclusion criteria were acute cholecystitis (AC) and other combined surgeries. One-to-one propensity score matching was performed between the RSSC and SILC or CMLC. RESULTS Of the 157 patients included, 39 (24.8%) underwent RSSC, 32 (20.4%) underwent SILC, and 86 (54.8%) underwent CMLC. In a propensity score-matched cohort between RSSC and SILC (32 patients in each group), the number of additional analgesic injections was significantly lower in the RSSC group than in the SILC group (0.7 vs. 1.3, p = 0.002), and postoperative pain scores were also significantly lower at 6 h (2.8 vs. 3.6, p = 0.004) and 24 h (2.6 vs. 3.3, p = 0.021) after surgery in the RSSC group than in the SILC group. In a propensity score-matched cohort between RSSC and CMLC (23 patients in each group), the number of additional analgesic injections was significantly lower in the RSSC group than in the CMLC group (0.7 vs. 1.3, p = 0.005), and postoperative pain scores were also significantly lower at 6 h after surgery (2.9 vs. 3.7, p = 0.025) in the RSSC group than in the CMLC group. CONCLUSION This study demonstrated that RSSC is helpful in reducing postoperative pain and the use of additional analgesics compared to both SILC and CMLC.
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Affiliation(s)
- Seung Jae Lee
- Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea
| | - Ju Ik Moon
- Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea.
| | - In Seok Choi
- Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea
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Rasa HK, Erdemir A. Our initial single port robotic cholecystectomy experience: A feasible and safe option for benign gallbladder diseases. World J Gastrointest Endosc 2022; 14:769-776. [PMID: 36567824 PMCID: PMC9782565 DOI: 10.4253/wjge.v14.i12.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although single-port laparoscopic cholecystectomy has been performed for over 25 years, it is still not popular. The narrow working space used in this surgery limits the movement of instruments and causes ergonomic challenges. Robotic surgery not only resolves the ergonomic challenges of single-port laparoscopic surgery but is also considered a good option with its additional technical advantages, like a three-dimensional display and not being affected by tremors. However, the extent to which these technical and ergonomic advantages positively affect the surgical outcomes and how safe the single-port robotic surgeries need to be assessed for each particular surgery.
AIM To evaluate the feasibility and safety of single-port robotic cholecystectomy for patients with cholelithiasis.
METHODS The electronic records of the first 40 consecutive patients with gallbladder lithiasis who underwent single-port robotic cholecystectomy from 2013 to 2021 were analyzed retrospectively. In addition to the demographic characteristics of the patients, we analyzed American Society of Anesthesiologists (ASA) scores and body mass index. The presence of an accompanying umbilical hernia was also noted. The amount of blood loss during the operation, the necessity to place a drain in the subhepatic area, and the need to use grafts during the closure of the fascia of the port site were determined. Hospital stay, readmission rates, perioperative and postoperative complications, the Clavien-Dindo complication scores and postoperative analgesia requirements were also evaluated.
RESULTS The mean age of the 40 patients included in the study was 49.5 ± 11.6 years, and 26 were female (65.0%). The umbilical hernia was present in 24 (60.0%) patients, with a body mass index median of 29.3 kg/m2 and a mean of 29.7 ± 5.2 kg/m2. Fifteen (37.5%) of the patients were evaluated as ASA I, 18 (45.0%) as ASA II, and 7 (17.5%) as ASA III. The mean bleeding amount during the operation was 58.4 ± 55.8 mL, and drain placement was required in 12 patients (30.0%). After port removal, graft reinforcement during fascia closure was preferred in 14 patients (35.0%). The median operation time was 93.5 min and the mean was 101.2 ± 27.0 min. The mean hospital stay was 1.4 ± 0.6 d, and 1 patient was readmitted to the hospital due to pain (2.5%). Clavien-Dindo I complications were seen in 14 patients (35.0%), and five (12.5%) complications were wound site problems.
CONCLUSION In addition to the technological and ergonomic advantages robotic surgery provides surgeons, our study strongly supports that single-port robotic cholecystectomy is a feasible and safe option for treating patients with gallstones.
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Affiliation(s)
- Huseyin Kemal Rasa
- Department of General Surgery, Anadolu Medical Center Hospital, Kocaeli 41400, Turkey
| | - Ayhan Erdemir
- Department of General Surgery, Anadolu Medical Center Hospital, Kocaeli 41400, Turkey
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Bosi HR, Rombaldi MC, Zaniratti T, Castilhos FO, Sbaraini M, Grossi JV, Pretto GG, Cavazzola LT. Does single‐site robotic surgery makes sense for gallbladder surgery? Int J Med Robot 2022; 18:e2363. [DOI: 10.1002/rcs.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/13/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Henrique Rasia Bosi
- Department of Surgery Hospital de Clínicas de Porto Alegre Porto Alegre Brazil
| | | | - Thamyres Zaniratti
- Faculdade de Medicina Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | | | - Mariana Sbaraini
- Faculdade de Medicina Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | | | - Guilherme Gonçalves Pretto
- Department of Surgery Hospital de Clínicas de Porto Alegre Porto Alegre Brazil
- Department of Surgery Hospital Moinhos de Vento Porto Alegre Brazil
| | - Leandro Totti Cavazzola
- Department of Surgery Hospital de Clínicas de Porto Alegre Porto Alegre Brazil
- Department of Surgery Hospital Moinhos de Vento Porto Alegre Brazil
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Kim WJ, Choi SB, Kim WB. Feasibility and Efficacy of Single-Port Robotic Cholecystectomy Using the da Vinci SP® Platform. JSLS 2022; 26:JSLS.2021.00091. [PMID: 35815324 PMCID: PMC9205460 DOI: 10.4293/jsls.2021.00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Background Single-incision laparoscopic cholecystectomy, first introduced in 1995, features acceptable cosmetic outcomes and postoperative pain control. The outcomes of single-port cholecystectomy by laparoscopy and robots were recently examined in many studies owing to surgeon and patient preference for minimally invasive surgery. A next-level da Vinci robotic platform was recently released. This study aimed to evaluate the feasibility and efficacy of robotic cholecystectomy (RC) using the da Vinci SP® system. Methods In this retrospective observational single-center study, we analyzed the medical records of 304 patients who underwent RC between March 1, 2017 and May 31, 2021. Results Of the 304 patients, the da Vinci Xi® (Xi) was used in 159 and the da Vinci SP® (SP) was used in 145. The mean operation time was 45.7 mins in the SP group versus 49.8 mins in the Xi group. The mean docking time of the SP group was shorter than that of the Xi group (5.7 min vs 8.8 min; p = 0.024). The mean immediate postoperative numerical rating scale (NRS) score was 4.0 in the SP group and 4.3 in the Xi group, showing a significant difference (p = 0.003). A separate analysis of only patients with acute cholecystitis treated with the da Vinci SP® showed that the immediate postoperative NRS score in the acute group was higher than that in the nonacute group. Conclusions This study demonstrated acceptable results of single-site cholecystectomy using da Vinci SP®. Thus, pure single-port RC using the da Vinci SP® for various benign gallbladder diseases may be an excellent treatment option.
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Affiliation(s)
- Wan-Joon Kim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea
| | - Sae-Byeol Choi
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea
| | - Wan-Bae Kim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea
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Berlet M, Jell A, Bulian D, Friess H, Wilhelm D. [Clinical value of alternative technologies to standard laparoscopic cholecystectomy - single port, reduced port, robotics, NOTES]. Chirurg 2022; 93:566-576. [PMID: 35226123 DOI: 10.1007/s00104-022-01608-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
Surgical interventions should ideally treat an existing disease curatively and achieve this with a low complication rate and minimal trauma. In this sense, laparoscopic cholecystectomy has become established as the recognized standard for the treatment of cholecystolithiasis. Newer procedures, such as single-port surgery or natural orifice transluminal endoscopic surgery (NOTES) have recently emerged to reduce the already low interventional trauma even further and to provide a better cosmetic outcome. With all new methods the main aim is the reduction of the transabdominal access points. Based on published results and diagnosis-related groups (DRG) data, this article examines whether this goal has been achieved, also with respect to the overall quality of treatment and the complication rates. In this context and in addition to the already mentioned approaches, robotic cholecystectomy and the reduced port approach are also considered.
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Affiliation(s)
- M Berlet
- Fakultät für Medizin, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
- Forschungsgruppe MITI, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, München, Deutschland
| | - A Jell
- Fakultät für Medizin, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
- Forschungsgruppe MITI, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, München, Deutschland
| | - D Bulian
- Klinik für Viszeral‑, Tumor‑, Transplantations- und Gefäßchirurgie, Zentrum für interdisziplinäre Viszeralmedizin (ZIV), Kliniken der Stadt Köln gGmbH, Köln, Deutschland
| | - H Friess
- Fakultät für Medizin, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
| | - D Wilhelm
- Fakultät für Medizin, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland.
- Forschungsgruppe MITI, Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, München, Deutschland.
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Comparison of short- and long-term postoperative occurrences after robotic single-incision cholecystectomy versus multiport laparoscopic cholecystectomy. Surg Endosc 2021; 36:2357-2364. [PMID: 33938991 DOI: 10.1007/s00464-021-08513-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Long-term outcomes of SIRC are not well established. Furthermore, SIRC is only now being considered more frequently for patients with independent risk factors for PSH, such as obesity. As such, the paucity of data on longer-term post-surgical outcomes of SIRC is particularly notable as it pertains to obese patients. METHODS All patients undergoing cholecystectomy performed by two surgeons at our institution from 2008-2018 were reviewed. Our inclusion criteria were patients who underwent SIRC or multiport laparoscopic cholecystectomy (MPLC) and had at least one month of postoperative follow-up. Patients who underwent additional procedures at the time of cholecystectomy were excluded. Our outcomes of interest were the 30-day POC rate and the long-term PSH rate. Analysis was conducted on an intention-to-treat basis, using logistic regression analysis for POC and time-to-event analysis for PSH. RESULTS We examined 584 patients who underwent either SIRC (51%) or MPLC (49%). Of the 296 patients who underwent SIRC, 15 (5%) developed a POC and 23 (8%) developed a PSH. Of the 288 patients who underwent MPLC, 11 (4%) developed a POC, and 28 (10%) developed a PSH. Procedure group and obesity was not associated with the risk of POC (p = 0.29, p = 0.21, respectively). Procedure group was not associated with an increased risk of PSH (p = 0.29). Obese patients, however, were 1.94 times more likely to develop PSH compared to non-obese patients overall (p = 0.02). CONCLUSIONS There is no statistically significant difference in POC and PSH rate following SIRC when compared with MPLC in patients in the same BMI group. Male gender and prior abdominal surgery are risk factors for POC, while advancing age and obesity are risk factors for PSH.
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Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review. Updates Surg 2021; 73:2039-2046. [PMID: 33886106 DOI: 10.1007/s13304-021-01056-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/13/2021] [Indexed: 12/15/2022]
Abstract
The role of single-incision laparoscopic cholecystectomy (SILC) and single-incision robotic cholecystectomy (SIRC) is still unclear. We update the summarization of the feasibility and safety of SILC and SIRC. A comprehensive search of SILC and SIRC of English literature published on PubMed database between January 2015 and November 2020 was performed. A total of 70 articles were included: 41 covering SILC alone, 21 showing SIRC alone, 7 reporting both, and 1 study not specified. In total, 7828 cases were recorded (SILC/SIRC/not specified, 6234/1544/50); and the gender of 7423 cases was definitively reported: the female rate was 64.0% (SILC/SIRC/not specified, 62.1%/71.5%/74.0%). The weighted mean for body mass index (BMI), operative time, blood loss and post-operative hospital stay was 25.5 kg/m2 (SILC/SIRC, 25.0/27.0 kg/m2), 73.8 min (SILC/SIRC, 68.2/88.8 min), 12.6 mL (SILC/SIRC, 12.1/14.8 mL) and 2.5 days (SILC/SIRC, 2.8/1.9 days), respectively. The pooled prevalence of an additional port, conversion to open surgery, post-operative complications, intraoperative biliary injury, and incisional hernia was 4.1% (SILC/SIRC, 4.7%/1.9%), 0.9% (SILC/SIRC, 0.7%/1.5%), 5.9% (SILC/SIRC, 6.2%/4.1%), 0.1% (SILC/SIRC, 0.2%/0.09%), and 2.1% (SILC/SIRC, 1.4%/4.8%), respectively. Compared with conventional laparoscopic cholecystectomy, SIRC has experienced more postoperative incisional hernias (risk difference = 0.05, 95% confidence interval 0.02-0.07; P < 0.0001). By far, SILC and SIRC have not been considered a standard procedure. With the innovation of medical devices and gradual accumulation of surgical experience, feasibility and safety of performing SILC and SIRC will improve.
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Lee SM, Lim JH. Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy. Ann Hepatobiliary Pancreat Surg 2021; 25:78-83. [PMID: 33649258 PMCID: PMC7952663 DOI: 10.14701/ahbps.2021.25.1.78] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022] Open
Abstract
Backgrounds/Aims Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. However, as a result of the ongoing trend toward minimally invasive laparoscopy, single-incision laparoscopic cholecystectomy (SILC) has evolved. Single-incision robotic cholecystectomy (SIRC) can overcome several limitations of manual SILC. The purpose of this study is to evaluate and compare the safety and feasibility of SIRC and SILC. Methods This study retrospectively reviewed data for all patients who underwent SIRC or SILC from March 2018 to July 2019 in a single institution. The following variables were analyzed: age, sex, body mass index, pain scale, length of stay, and complications. The data were analyzed using the Independent two sample t-test or the Fisher’s exact test. Results A total of 343 patients underwent SIRC or SILC during the study period. After excluding patients with acute cholecystitis, 197 SIRC and 103 SILC patients were analyzed in this study. The surgery time and postoperative hospital stay did not differ between SIRC and SILC. However, the SIRC patients experienced less bile spillage during the surgery than did the SILC patients (SIRC vs. SILC: 24 (23.3%) vs. 11 (5.6%) cases, respectively; p<0.001). Although there was no difference in the incidence of postoperative complications between procedures, additional pain control was administered more frequently in SILC patients (SILC 1.08±0.893, SIRC 0.58±0.795; p<0.001). Conclusions While both SILC and SIRC are effective for single-incision cholecystectomy, SIRC was superior to SILC in terms of technical stability. Moreover, it has the advantage of postoperative pain control.
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Affiliation(s)
- Sun Min Lee
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Hong Lim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Jeong Jang E, Kang SH, Kim KW. Early Outcomes of Robotic Single Site Cholecystectomy Using the DaVinci Xi® System. JSLS 2021; 25:JSLS.2020.00082. [PMID: 33628004 PMCID: PMC7881280 DOI: 10.4293/jsls.2020.00082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Robotic surgery has become an established alternative to conventional laparoscopy or single site laparoscopy by solving the problems of angulation, improving the ergonomics of single-incision technology, and overcoming the intrinsic limitations of single-incision laparoscopy. Although the robotic single site technology is non-wristed and, unlike other conventional robotic instruments, only provides rotation, the ergonomics are nevertheless excellent. Therefore, the objective of this study is to present our initial experience in robotic single site cholecystectomy (RSSC) by a surgeon. Through this, we suggest that RSSC could be a feasible and safe procedure for overcoming the shortcomings of single incision laparoscopic cholecystectomy (SILC). METHODS This study is a retrospective data review of 74 patients who underwent RSSC between April 2019 and August 2020 at our institution. The demographic, pre-, and postoperative data were retrospectively collected. RESULTS A total of 74 patients underwent RSSC. The mean age of patients was 44.7 ± 9.5 years, and their mean body mass index was 24 ± 3 kg/m2. Symptomatic gallbladder stone (56.8%) was the most common pre-operative diagnosis. Mean of total operation and docking times was 39.3 ± 12.5 (20 - 85) and 7.6 ± 3.1 (4 - 20) minutes, respectively. There was no conversion, additional port insertion, bleeding, or intra-operative complication; however, one patient had wound seroma. CONCLUSIONS RSSC for uncomplicated gallbladder disease may serve as an excellent alternative to SILC or conventional laparoscopic cholecystectomy because of its low complication rates, good cosmesis, and ease of reproducibility without a substantial learning curve.
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Affiliation(s)
- Eun Jeong Jang
- Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
| | - Sung Hwa Kang
- Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
| | - Kwan Woo Kim
- Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
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Beltzer C, Gradinger K, Bachmann R, Axt S, Dippel H, Schmidt R. Robotic multiport versus robotic single-site cholecystectomy: a retrospective single-centre experience of 142 cases. Eur Surg 2020. [DOI: 10.1007/s10353-019-00619-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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A Comparative Study of Needlescopic Grasper Assisted Single Incision versus Three Port versus Pure Single Incision Laparoscopic Cholecystectomy. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2019; 22:137-138. [PMID: 35601373 PMCID: PMC8980166 DOI: 10.7602/jmis.2019.22.4.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022]
Abstract
This study compared the surgical outcomes of single-incision with needlescopic grasper (nSILC) versus three-port (TPLC) versus pure single-incision laparoscopic cholecystectomies (pSILC). The present study showed similar surgical outcomes between the pSILC and nSILC procedures. However, the operative time for the nSILC group was longer than that for the TPLC group but shorter than that for the pSILC group. Therefore, nSILC is a feasible surgical procedure for patients with benign gallbladder disease compared to TPLC and an effective approach to overcome the limitations of pSILC.
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A Comparative Study of Needlescopic Grasper Assisted Single Incision versus Three-Port versus Pure Single Incision Laparoscopic Cholecystectomy. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2019; 22:171-176. [PMID: 35601375 PMCID: PMC8980142 DOI: 10.7602/jmis.2019.22.4.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/29/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
Purpose Single incision laparoscopic cholecystectomy (SILC) is a surgical method to treat gallbladder disease designed to reduce postoperative pain and improve cosmetic results. However, pure SILC (pSILC) has several inherent limitations. In this study, we report the surgical outcomes of SILC with needlescopic grasper (nSILC) compared with those of pSILC and conventional three-port laparoscopic cholecystectomy (TPLC). Methods This retrospective study enrolled 103 patients who underwent laparoscopic cholecystectomy for benign gallbladder disease in our hospital between January 2013 and January 2015. Among them, 33 patients underwent pSILC, 35 underwent nSILC, and 35 underwent TPLC. We collected demographic characteristics and operative data to analyze outcomes between groups. Results All procedures were done by laparoscopy and the gallbladder of each patient was completely removed. Women and younger patients were more to undergo SILC than TPLC. Analysis showed that the operation time of the nSILC group was longer than that of the TPLC group, but shorter than that of the pSILC group (skin to skin operation time [pSILC: 65.2±19.1 min, nSILC: 49.7±12.9 min, and TPLC: 43.4±14.7 min, p<0.001], and major procedure time [pSILC: 42.2±18.7 min, nSILC: 25.9±8.9 min, and TPLC: 23.4±12.7 min, p<0.001]). There were no significant differences between the groups for patient visual analogue scale score, length of hospital stay, or intraoperative blood loss. Conclusion nSILC is feasible surgical method in patients with benign gallbladder disease compared to TPLC, and that is an effective procedure to overcome the disadvantage of pSILC.
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Minimally Invasive Single-Site Cholecystectomy in Obese Patients: Laparoscopic vs. Robotic. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2019; 22:101-105. [PMID: 35599698 PMCID: PMC8980161 DOI: 10.7602/jmis.2019.22.3.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/24/2019] [Accepted: 06/18/2019] [Indexed: 01/26/2023]
Abstract
Purpose Laparoscopic cholecystectomy is treatment method for management of benign gallbladder diseases. Further attempts are made to operate single-port laparoscopic cholecystectomy. However, single-port laparoscopic cholecystectomy, the procedure remains technically difficult, especially in obese patient. Recently, a robotic surgical system for minimal invasive surgery was introduced to overcome the limitations of conventional laparoscopic surgery. Methods From April 2009 to August 2017, we retrospectively reviewed the medical records of patients with single-site, minimally invasive (laparoscopic and robotic) cholecystectomy with high BMI (>25 kg/m2). We analyzed general characteristics and perioperative outcomes between the single-fulcrum laparoscopic cholecystectomy group and the robotic single-site cholecystectomy (RSSC) group. Results Operation time (57.56±11.10 vs 98.5±12.28 p<0.001) was significantly longer and postoperative pain score (3.61 vs 5.15 p=0.000) was significantly higher in the robotic single-site cholecystectomy (RSSC) group, but the actual dissection time (25.85±11.09 vs 25.79±13.35 p=0.978) was not significantly different between the two approaches. Iatrogenic gallbladder perforation, (13 vs 6 p=0.005), patients undergoing RSSC showed a significantly smaller amount than did those undergoing single-fulcrum laparoscopic cholecystectomy (SFLC). Conclusion It is difficult to say for certain that RSSC is clearly better than SFLC in obese patients. However, because of the technical convenience and efficiency of surgery with RSSC, RSSC can be practically worthwhile. Further study is mandatory.
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