Cholecystectomy by using a surgical robotic system

Abstract

Because of their frequency, hepato-biliary procedures have been the gateway for innovation to permeate into the realm of general surgery. Robotics and singleincision techniques are the latest manifestation in the evolution of minimally invasive surgery. Enthusiasm for the latter has increased due to its inarguably superior cosmetic result. Nevertheless, there are several technical disadvantages associated with this approach that have raised several concerns. The robotic platform may provide a solution to these issues. We analyze the strengths and weaknesses of the robotic system for cholecystectomy and its relation to single site technology. We review all available literature addressing robotic single site cholecystectomy. Due to the advent of specific robotic single site technology, many of the challenges commonly associated with single site cholecystectomy have been alleviated. Although this novel approachhas not yet been extensively tested, the available evidence suggests that it is at least equivalent to LC in selected patients. Robotic single site cholecystectomy is safe and feasible and adequately compensates for many of the challenges commonly associated with conventional single site cholecystectomy. Large, high-quality studies are needed to further clarify the role of this procedure and its value as part of the surgeon's armamentarium.

How I Do It: Robotic Choledochoscopy

“…The advantages of using robotic surgical techniques over laparoscopic surgical techniques include improved ergonomics, greater dexterity, and the ability to have 3D visualization. 7,11,12 Robotic surgery has shown a reduced learning curve for gastric bypass procedures, where the learning curve of the robotic surgery was <10 cases and the laparoscopic case learning curve between 80 and 100 cases. 7 The utilization of robotic techniques involving the gallbladder, including cholecystectomy, is beginning to increase as well.…”

“…A study by Tatarian et al 11 found that between 2015 and 2018 robotic surgery used in bariatric surgery, primarily in sleeve gastrectomy, increased from 6.7% to 10.3%. The advantages of using robotic surgical techniques over laparoscopic surgical techniques include improved ergonomics, greater dexterity, and the ability to have 3D visualization 7,11,12 . Robotic surgery has shown a reduced learning curve for gastric bypass procedures, where the learning curve of the robotic surgery was <10 cases and the laparoscopic case learning curve between 80 and 100 cases 7 …”