Institutional members access full text with Ovid®

Single-Site Robotic Cholecystectomy in a Broadly Inclusive Patient Population: A Prospective Study

Vidovszky, Tamas J. MD; Carr, Aaron D. MD; Farinholt, Gina N. MD; Ho, Hung S. MD; Smith, William H. BS; Ali, Mohamed R. MD

doi: 10.1097/SLA.0000000000000295
Original Articles

Objectives: To describe our initial experience with single-site robotic cholecystectomy (SSRC) and its applicability to a broad segment of patients.

Background: At the initiation of our study, there were only 3 published reports on SSRC. These initial studies had limited inclusion criteria. We present our experience with the technical aspects and patient outcomes of SSRC in a broadly inclusive patient population.

Methods: Prospective cohort study from January 2012 to January 2013, in which 95 patients underwent SSRC. Procedural times, postoperative complications, delayed hospital discharges, and re-admissions were evaluated.

Results: Patients were predominantly female (71.6%) had mean age of 45.2 ± 6.1 years and mean body mass index (BMI) of 30.1 ± 7.1 kg/m2. Overall, mean total operative time (TOT) for all patients (n = 95) was 88.63 ± 32.0 (range: 49–220) minutes. SSRC was not completed in 8 (8.42%) patients: 6 conversions to laparoscopy, 1 conversion to open, and 1 aborted case. The group of patients who were able to complete SSRC (n = 87) had a mean TOT of 83.5 ± 24.5 minutes and mean operative robotic time (RT) of 39.6 ± 15.2 minutes. RT was longer in patients with intra-abdominal adhesions (P = 0.0139) and higher BMI (P = 0.03). A minority of patients required hospital admission (11.6%), readmission (6.3%), or reoperation (1.1%). No bile duct injury or death occurred.

Conclusions: SSRC is safe and has a manageable learning curve. Patient factors, such as obesity, did not significantly affect conversion rates or TOTs. SSRC is a promising new technique, which can be offered to a wide array of patients.

This prospective study describes a cohort of 95 patients who underwent single-site robotic cholecystectomy (SSRC). Our study included a broad segment of patients and did not limit participation based on previous surgery, body mass index, or cholecystitis. These patient factors did not significantly affect operative outcomes.

From the Innovative Surgery of the Alimentary Tract (iSAT) Institute, Department of Surgery, University of California, Davis in Sacramento.

Reprints: Mohamed R. Ali, MD, Department of Surgery, University of California, Davis, 2221 Stockton Boulevard, Cypress Building, Sacramento, CA 95817. E-mail: mrali@ucdavis.edu.

Presented at the 84th Annual Meeting of the Pacific Coast Surgical Association Scientific Session V, Kauai, HI, February 18, 2013.

Disclosure: Dr Vidovszky received honoraria from Intuitive Surgical. For the remaining authors, none were declared. The UC Davis MIS fellowship is supported by the Foundation for Surgical Fellowships. The authors declare no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.