Single-site robotic cholecystectomy in a broadly inclusive patient population: A prospective study

Tamas J Vidovszky, Aaron D. Carr, Gina N. Farinholt, Hung S Ho, William H. Smith, Mohamed R Ali

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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/m. 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.

Original languageEnglish (US)
Pages (from-to)134-141
Number of pages8
JournalAnnals of Surgery
Volume260
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Robotics
Cholecystectomy
Prospective Studies
Population
Operative Time
Body Mass Index
Learning Curve
Bile Ducts
Reoperation
Laparoscopy
Cohort Studies
Obesity

Keywords

  • cholecystectomy
  • robotic surgery
  • SILS
  • Single Site
  • SSRC

ASJC Scopus subject areas

  • Surgery

Cite this

Single-site robotic cholecystectomy in a broadly inclusive patient population : A prospective study. / Vidovszky, Tamas J; Carr, Aaron D.; Farinholt, Gina N.; Ho, Hung S; Smith, William H.; Ali, Mohamed R.

In: Annals of Surgery, Vol. 260, No. 1, 2014, p. 134-141.

Research output: Contribution to journalArticle

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abstract = "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/m. 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.",
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