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Annals of Surgery:
doi: 10.1097/SLA.0000000000000295
Original Articles

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

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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.

© 2014 by Lippincott Williams & Wilkins.


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