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Published in: Surgical Endoscopy 7/2016

01-07-2016

A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases

Authors: Anthony Gonzalez, Christian Hernandez Murcia, Rey Romero, Ernesto Escobar, Pedro Garcia, Gail Walker, Michelle Gallas, Eugene Dickens, Bruce McIntosh, William Norwood, Keith Kim, Jorge Rabaza, Don Parris

Published in: Surgical Endoscopy | Issue 7/2016

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Abstract

Background

Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC).

Methods

Medical records of consecutive patients who underwent SIRC were retrospectively reviewed. All procedures were performed by six surgeons at five different North American centers involved in the study. All patients included in the study underwent a cholecystectomy attempted through single site at the umbilicus, using the da Vinci® Surgical System (Intuitive Surgical Inc. Sunnyvale, CA).

Results

A total of 465 patients met study criteria. Median age was 48 years (range 18–89); 351 (75.5 %) were female and 304 (66.4 %) were overweight or obese. Except for gender, case characteristics differed significantly by surgeon/site. Previous abdominal surgery was reported for 226 (48.6 %) cases. SIRC was successfully completed in 455 (97.8 %) cases, and there were no conversions to open surgery. Median surgical time was 52 min with a decreasing trend after 55–85 cases. Male gender, obesity and diagnoses other than biliary dyskinesia were independent predictors of longer surgical times. The complication rate was 2.6 %.

Conclusions

Our large, multicenter study demonstrates that robotic single-site cholecystectomy is safe and feasible in a wide range of patients.
Literature
2.
go back to reference Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695CrossRefPubMed Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695CrossRefPubMed
3.
go back to reference Zorron R, Filgueiras M, Maggioni LC, Pombo L, Lopes Carvalho G, Lacerda Oliveira A (2007) NOTES. Transvaginal cholecystectomy: report of the first case. Surg Innov 14:279–283CrossRefPubMed Zorron R, Filgueiras M, Maggioni LC, Pombo L, Lopes Carvalho G, Lacerda Oliveira A (2007) NOTES. Transvaginal cholecystectomy: report of the first case. Surg Innov 14:279–283CrossRefPubMed
4.
go back to reference Coomber RS, Sodergren MH, Clark J, Teare J, Yang GZ, Darzi A (2012) Natural orifice translumenal endoscopic surgery applications in clinical practice. World J Gastrointest Endosc 4:65–74CrossRefPubMedPubMedCentral Coomber RS, Sodergren MH, Clark J, Teare J, Yang GZ, Darzi A (2012) Natural orifice translumenal endoscopic surgery applications in clinical practice. World J Gastrointest Endosc 4:65–74CrossRefPubMedPubMedCentral
5.
go back to reference Sodergren MH, Aslanyan A, Mcgregor CG, Purkayastha S, Malhotra S, Darzi A, Paraskeva P (2014) Pain, well-being, body image and cosmesis: a comparison of single-port and four-port laparoscopic cholecystectomy. Minim Invasive Ther Allied Technol 23:223–229CrossRefPubMed Sodergren MH, Aslanyan A, Mcgregor CG, Purkayastha S, Malhotra S, Darzi A, Paraskeva P (2014) Pain, well-being, body image and cosmesis: a comparison of single-port and four-port laparoscopic cholecystectomy. Minim Invasive Ther Allied Technol 23:223–229CrossRefPubMed
6.
go back to reference Jørgensen LN, Rosenberg J, Al-Tayar H, Assaadzadeh S, Helgstrand F, Bisgaard T (2014) Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy. Br J Surg 101:347–355CrossRefPubMed Jørgensen LN, Rosenberg J, Al-Tayar H, Assaadzadeh S, Helgstrand F, Bisgaard T (2014) Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy. Br J Surg 101:347–355CrossRefPubMed
7.
go back to reference Qiu J, Yuan H, Chen S, He Z, Han P, Wu H (2013) Single-port versus conventional multiport laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials and nonrandomized studies. J Laparoendosc Adv Surg Tech 23:815–831CrossRef Qiu J, Yuan H, Chen S, He Z, Han P, Wu H (2013) Single-port versus conventional multiport laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials and nonrandomized studies. J Laparoendosc Adv Surg Tech 23:815–831CrossRef
8.
9.
go back to reference Oruc MT, Ugurlu MU (2013) Extraumbilical single-incision laparoscopic cholecystectomy with standard laparoscopic instruments. Scand J Surg 102:209–214CrossRefPubMed Oruc MT, Ugurlu MU (2013) Extraumbilical single-incision laparoscopic cholecystectomy with standard laparoscopic instruments. Scand J Surg 102:209–214CrossRefPubMed
10.
go back to reference Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ et al (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212:113–118CrossRefPubMed Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ et al (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212:113–118CrossRefPubMed
11.
go back to reference Romero RJ, Arad JK, Kosanovic R, Lamoureux J, Gonzalez AM (2014) Impact of fellowship during single-incision laparoscopic cholecystectomy. JSLS 18:8–13CrossRefPubMedPubMedCentral Romero RJ, Arad JK, Kosanovic R, Lamoureux J, Gonzalez AM (2014) Impact of fellowship during single-incision laparoscopic cholecystectomy. JSLS 18:8–13CrossRefPubMedPubMedCentral
12.
go back to reference Arezzo A, Scozzari G, Famiglietti F, Passera R, Morino M (2013) Is single-incision laparoscopic cholecystectomy safe? Results of a systematic review and meta-analysis. Surg Endosc 27:2293–2304CrossRefPubMed Arezzo A, Scozzari G, Famiglietti F, Passera R, Morino M (2013) Is single-incision laparoscopic cholecystectomy safe? Results of a systematic review and meta-analysis. Surg Endosc 27:2293–2304CrossRefPubMed
14.
go back to reference Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G et al (2013) Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 216:1037–1047CrossRefPubMed Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G et al (2013) Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 216:1037–1047CrossRefPubMed
15.
go back to reference Joseph M, Phillips MR, Farrell TM, Rupp CC (2012) Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg 256:1–6CrossRefPubMed Joseph M, Phillips MR, Farrell TM, Rupp CC (2012) Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg 256:1–6CrossRefPubMed
16.
go back to reference Kurpiewski W, Pesta W, Kowalczyk M, Głowacki L, Juśkiewicz W, Szynkarczuk R et al (2012) The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy. Videosurg Miniinv 7:286–293CrossRef Kurpiewski W, Pesta W, Kowalczyk M, Głowacki L, Juśkiewicz W, Szynkarczuk R et al (2012) The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy. Videosurg Miniinv 7:286–293CrossRef
17.
go back to reference Ross S, Rosemurgy A, Albrink M, Choung E, Dapri G, Gallagher S et al (2012) Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc 26:2711–2716CrossRefPubMed Ross S, Rosemurgy A, Albrink M, Choung E, Dapri G, Gallagher S et al (2012) Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc 26:2711–2716CrossRefPubMed
18.
go back to reference Jung GO, Park DE, Chae KM (2012) Clinical results between single incision laparoscopic cholecystectomy and conventional 3-port laparoscopic cholecystectomy: prospective case-matched analysis in single institution. J Korean Surg Soc 83:374–380CrossRefPubMedPubMedCentral Jung GO, Park DE, Chae KM (2012) Clinical results between single incision laparoscopic cholecystectomy and conventional 3-port laparoscopic cholecystectomy: prospective case-matched analysis in single institution. J Korean Surg Soc 83:374–380CrossRefPubMedPubMedCentral
20.
go back to reference Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J et al (2011) First human surgery with novel single-port robotic system: cholecystectomy using the da Vinci single-site platform. Surg Endosc 25:3566–3573CrossRefPubMed Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J et al (2011) First human surgery with novel single-port robotic system: cholecystectomy using the da Vinci single-site platform. Surg Endosc 25:3566–3573CrossRefPubMed
21.
go back to reference Wren SM, Curet MJ (2011) Single-port robotic cholecystectomy: results from a first human use clinical study of the new da Vinci single-site surgical platform. Arch Surg 146:1122–1127CrossRefPubMed Wren SM, Curet MJ (2011) Single-port robotic cholecystectomy: results from a first human use clinical study of the new da Vinci single-site surgical platform. Arch Surg 146:1122–1127CrossRefPubMed
22.
go back to reference Wohl H (1997) The cusum plot: its utility in the analysis of clinical data. N Engl J Med 296:1044–1045CrossRef Wohl H (1997) The cusum plot: its utility in the analysis of clinical data. N Engl J Med 296:1044–1045CrossRef
23.
go back to reference Way LW, Stewart L, Gantert W, Liu K, Lee CM, Whang K et al (2003) Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 237:460–469PubMedPubMedCentral Way LW, Stewart L, Gantert W, Liu K, Lee CM, Whang K et al (2003) Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 237:460–469PubMedPubMedCentral
24.
go back to reference Antoniou SA, Pointner R, Granderath FA (2011) Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc 25:367–377CrossRefPubMed Antoniou SA, Pointner R, Granderath FA (2011) Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc 25:367–377CrossRefPubMed
26.
go back to reference Ingraham A, Cohen M, Ko C, Hall B (2010) A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 211:176–186CrossRefPubMed Ingraham A, Cohen M, Ko C, Hall B (2010) A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 211:176–186CrossRefPubMed
27.
go back to reference Keus F, de Jong JA, Goozsen HG, van Laarhoven CJ (2006) Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis. Cohcrane Database Syst Rev. doi:10.1002/14651858.CD006231 Keus F, de Jong JA, Goozsen HG, van Laarhoven CJ (2006) Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis. Cohcrane Database Syst Rev. doi:10.​1002/​14651858.​CD006231
28.
go back to reference Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel Single-SIte (®)robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694CrossRefPubMed Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel Single-SIte (®)robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694CrossRefPubMed
29.
go back to reference Spinoglio G, Priora F, Bianchi PP, Lucido FS, Licciardello A, Maglione V et al (2013) Real-time near-infrared [NIR] fluorescent cholangiography in single-site robotic cholecystectomy [SSRC]: a single-institutional study. Surg Endosc 27:2156–2162CrossRefPubMed Spinoglio G, Priora F, Bianchi PP, Lucido FS, Licciardello A, Maglione V et al (2013) Real-time near-infrared [NIR] fluorescent cholangiography in single-site robotic cholecystectomy [SSRC]: a single-institutional study. Surg Endosc 27:2156–2162CrossRefPubMed
30.
go back to reference Buzad FA, Corne LM, Brown TC, Fagin RS, Hebert AE, Kaczmarek CA et al (2013) Single-site robotic cholecystectomy: efficiency and cost analysis. Int J Med Robot 9:365–370CrossRefPubMed Buzad FA, Corne LM, Brown TC, Fagin RS, Hebert AE, Kaczmarek CA et al (2013) Single-site robotic cholecystectomy: efficiency and cost analysis. Int J Med Robot 9:365–370CrossRefPubMed
31.
go back to reference Vidovszky TJ, Carr AD, Farinholt GN, Ho HS, Smith WH, Ali MR (2014) Single-site robotic cholecystectomy in a broadly inclusive patient population: a prospective study. Ann Surg 260:134–141CrossRefPubMed Vidovszky TJ, Carr AD, Farinholt GN, Ho HS, Smith WH, Ali MR (2014) Single-site robotic cholecystectomy in a broadly inclusive patient population: a prospective study. Ann Surg 260:134–141CrossRefPubMed
32.
go back to reference Morel P, Buchs NC, Iranmanesh P, Pugin F, Buehler L, Azagury DE et al (2014) Robotic single-site cholecystectomy. J Hepatobiliary Pancreat Sci 21:18–25CrossRefPubMed Morel P, Buchs NC, Iranmanesh P, Pugin F, Buehler L, Azagury DE et al (2014) Robotic single-site cholecystectomy. J Hepatobiliary Pancreat Sci 21:18–25CrossRefPubMed
33.
go back to reference Angus AA, Sahi SL, McIntosh BB (2014) Learning curve and early clinical outcomes for a robotic surgery novice performing robotic single site cholecystectomy. Int J Med Robot 10:203–207CrossRefPubMed Angus AA, Sahi SL, McIntosh BB (2014) Learning curve and early clinical outcomes for a robotic surgery novice performing robotic single site cholecystectomy. Int J Med Robot 10:203–207CrossRefPubMed
34.
go back to reference Gonzalez AM, Rabaza JR, Donkor C, Romero RJ, Kosanovic R, Verdeja JC (2013) Single-incision cholecystectomy: a comparative study of standard laparoscopic, robotic, and SPIDER platforms. Surg Endosc 27:4524–4531CrossRefPubMed Gonzalez AM, Rabaza JR, Donkor C, Romero RJ, Kosanovic R, Verdeja JC (2013) Single-incision cholecystectomy: a comparative study of standard laparoscopic, robotic, and SPIDER platforms. Surg Endosc 27:4524–4531CrossRefPubMed
35.
go back to reference Uras C, Böler DE, Ergüner I, Hamzaoğlu I (2014) Robotic single port cholecystectomy [R-LESS-C]: experience in 36 patients. Asian J Surg 37:115–119CrossRefPubMed Uras C, Böler DE, Ergüner I, Hamzaoğlu I (2014) Robotic single port cholecystectomy [R-LESS-C]: experience in 36 patients. Asian J Surg 37:115–119CrossRefPubMed
Metadata
Title
A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases
Authors
Anthony Gonzalez
Christian Hernandez Murcia
Rey Romero
Ernesto Escobar
Pedro Garcia
Gail Walker
Michelle Gallas
Eugene Dickens
Bruce McIntosh
William Norwood
Keith Kim
Jorge Rabaza
Don Parris
Publication date
01-07-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4583-1

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