Safety of single-incision robotic cholecystectomy for benign gallbladder disease: a systematic review

Migliore, M.; Arezzo, Alberto; Arolfo, Simone; Passera, Roberto; Morino, Mario

doi:10.1007/s00464-018-6300-3

Cited by 21 publications

(11 citation statements)

References 59 publications

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“…Over the five years since the first robotic surgery in 1999, the robotic system has evolved to a single-site platform, enabling single-incision surgeries to be practiced in multiple departments. Initial studies have demonstrated that robotic single-site technique is safe and has potential to resolve the technical limitations of conventional laparoscopy [6]. A recent RCT described benefits of R-LESS over LESS in terms of patients' outcome and surgeons' stress load [7].…”

Section: Discussionmentioning

confidence: 99%

Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy

2020

Clinical and Experimental Obstetrics & Gynecology

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With the quality ergonomics and rapid learning curve of the robotic surgery system taken into consideration, robotic laparoendoscopic single-site surgery (R-LESS) appears to be the best integration for maximizing the benefits of single-site surgery. However, there are drawbacks of robot-assisted procedures which include longer operative time and higher cost, because of this, we hypothesized that the burden of robotic surgery would be reduced if two surgeries could be completed within one session in R-LESS. Three cases of R-LESS were performed for combined hysterectomy and cholecystectomy in patients with concomitant benign uterine disease and cholecystopathy. The combined surgeries were successfully conducted without additional port insertion or conversion and included the benefits of decreased hospital stay, anesthesia risk, and cost compared with the sum of two separate surgeries. Therefore, in cases in which concomitant pathologies are detected in the abdominopelvic cavity, R-LESS can be an option for selected patients with the benefit of minimally invasive surgery.

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Section: Discussionmentioning

confidence: 99%

Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy

2020

Clinical and Experimental Obstetrics & Gynecology

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“…Previous studies have shown that, when comparing RSSC and LSSC, RSSC is safer, easier to learn, less stressful, and technically easier for the operator to perform. 7,9,16,17 Also, other investigations have detailed that the rates of major complications and open conversion are lower in patients with high BMI compared with cases of RSSC and standard laparoscopic cholecystectomy. 18 Therefore, when comparing RSSC and SFLC in high-BMI patients, RSSC seems to be a safer procedure associated with less morbidity.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Single-Site Cholecystectomy in Obese Patients: Laparoscopic vs. Robotic

Lee

Han

Roh

et al. 2019

J Minim Invasive Surg

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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/m 2). We analyzed general characteristics and perioperative outcomes between the singlefulcrum 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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“…[7][8][9] However, SILC is not widely performed because the narrow working space limits the movement of instruments and causes crowding between instruments. [10][11][12] In 2011, the da Vinci Single-Site Instrumentation and Accessories (Intuitive Surgical, Inc., Sunnyvale, CA, USA) system was developed to overcome these limitations. 12 The semirigid instruments cross each other within the trocar, so that the cannula entering from the left becomes the right-side operative instrument and vice-versa.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

Lee

Lim

2021

Ann Hepatobiliary Pancreat Surg

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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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Safety of single-incision robotic cholecystectomy for benign gallbladder disease: a systematic review

Cited by 21 publications

References 59 publications

Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy

Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy

Minimally Invasive Single-Site Cholecystectomy in Obese Patients: Laparoscopic vs. Robotic

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

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