Initial experiences of robotic SP cholecystectomy: a comparative analysis with robotic Si single-site cholecystectomy

Charles Jimenez Cruz, Frederick Huynh, Incheon Kang, Woo Jung Lee, Chang Moo Kang, Charles Jimenez Cruz, Frederick Huynh, Incheon Kang, Woo Jung Lee, Chang Moo Kang

Abstract

Purpose: The da Vinci SP robotic surgical system (Intuitive Surgical) offers pure SP with 4 lumens, which accommodates the fully-wristed endoscope and 3 arms with multijoint feature. We herein present our initial experience of the da Vinci SP surgical system in robotic single-site cholecystectomy.

Methods: Thirty consecutive patients with a preoperative diagnosis of gallstones and/or chronic cholecystitis who underwent robotic SP cholecystectomy (RSPC) using da Vinci SP surgical system from January to May 2019 were reviewed. The perioperative outcomes were assessed and compared with those performed using Si-robotic single-site surgical system.

Results: Mean docking time was 5.2 minutes. The mean actual dissection time was 14.6 minutes while the mean operation time was 75.1 minutes. Postoperative course was unremarkable and patients were discharged after a mean hospital stay of 1.5 days. In comparative analysis, operation time (109.5 ± 30.0 minutes vs. 75.1 ± 17.5 minutes, P = 0.001), docking time (11.9 ± 4.3 minutes vs. 5.2 ± 1.9 minutes, P = 0.001), actual dissection time (34.6 ± 18.4 minutes vs. 14.6 ± 5.1 minutes, P = 0.001), console time (58.7 ± 23.0 minutes vs. 32.4 ± 11.6 minutes, P = 0.001), immediate postoperative pain (4.6 ± 1.3 vs. 3.2 ± 1.0, P = 0.001), and pain prior to discharge (2.0 ± 0.6 vs. 1.4 ± 0.0, P = 0.002) were significantly improved in RSPC.

Conclusion: RSPC is feasible, safe, and effective. The perioperative outcomes are better compared with Si-robotic single-site surgical systems.

Keywords: Cholecystectomy; Gallstones; Robotics.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Copyright © 2021, the Korean Surgical Society.

Figures

Fig. 1. Trocar system of the robotic…
Fig. 1. Trocar system of the robotic SP cholecystectomy. (A) SP robotic system has pure single port with 4 lumens. Flexible scope and three individual instruments can be simply docked to the system (B–D).
Fig. 2. Procedure description of the robotic…
Fig. 2. Procedure description of the robotic SP cholecystectomy. With effective gallbladder retraction (A), calot trianlge is dissected by using remaining two robotic artms (B). (C) Cystic duct and artery are clipped under magnified operation field. (D) Final postoperative wound.

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