Single-incision cholecystectomy: a comparative study of standard laparoscopic, robotic, and SPIDER platforms

Abstract

The results of this study demonstrate similar results among the three platforms for most of the parameters measured. The SILC procedure appears to be superior to SIRC and SPIDER in terms of surgical time, but selection bias could be the cause. The SILS, SIRC, and SPIDER procedures all are similar in terms of complication profile. It can be concluded that SILC, SIRC, and SPIDER all are feasible and safe alternatives when used for single-incision cholecystectomy.

Laparoscopic cholecystectomy using a novel single-incision surgical platform through a standard 15mm trocar: initial experience and technical details

“…Compared to other devices, the platform also has greatly improved triangulation, range of motion, and tissue manipulation capabilities. Average operative time in our case series is comparable to previous collectives of single-site cholecystectomy [8]. One of our six cases has a significantly increased operative time compared to all other cases, which is attributed to chronic inflammation and clip applier malfunction resulting in a technically challenging dissection and suture ligation of the cystic artery and duct.…”

“…However, widespread adoption is limited by the uncomfortable work space from instrument collisions and restricted potential for improvement in outcomes due to rigid devices [7]. Flexible instruments are also available, but current technology does not achieve adequate triangulation for optimal surgical manipulation and visualization [8,9]. Additional limitations of current devices include large access incisions (25-30 mm) with potential for increased risk of incisional hernia, prolonged operative time, and increased risk of common bile duct injury [10,11].…”

SAGES TAVAC safety and effectiveness analysis: da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA)

“…With the introduction of the single-incision Da Vinci Ò robotic platform, several institutions have described their experience with this technology for robotic cholecystectomy [135][136][137][138][139][140][141][142][143][144][145]. It appears that, with adequate experience, the use of this technology for single-incision robotic-assisted cholecystectomy is safe and feasible.…”

Robotic versus laparoscopic rectal resection: is there any real difference? A comparative single center study

“…We underline that the robotic technique has to be considered as a system, allowing the integration of further applications, such as immunofluorescence and the identification of sentinel lymph nodes that may potentially enhance the oncological results of RRR. Moreover, the robotic system may simplify the use of other minimally invasive procedures, such as SILS and TEM . Once these future applications have been studied, we think we will finally find the real advantages of the robotic approach in rectal cancer resection.…”