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Real-time near-infrared fluorescent cholangiography could shorten operative time during robotic single-site cholecystectomy

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Abstract

Background

With the introduction of a new platform, robotic single-site cholecystectomy (RSSC) has been reported as feasible and safe for selected cases. In parallel, the development of real-time near-infrared fluorescent cholangiography using indocyanine green (ICG) has been seen as a help during the dissection, even if the data are still preliminary. The study purpose is to report our experience with ICG RSSC and compare the outcomes to standard RSSC.

Methods

From February 2011 to December 2011, 44 selected patients underwent RSSC for symptomatic cholelithiasis. Among them, 23 (52.3 %) were included in an experimental protocol using the ICG, and the remainder (47.7 %) underwent standard RSSC. There was no randomization. The endpoints were the perioperative outcomes. This is a prospective study, approved by our local Ethics Committee.

Results

There were no differences in terms of patients’ characteristics, except that there were more male patients in the ICG group (47.8 vs. 9.5 %; p = 0.008). Regarding the surgical data, the overall operative time was shorter for the ICG group, especially for patients with a body mass index (BMI) ≤25 (−24 min) but without reaching statistical significance (p = 0.06). For BMI >25, no differences were observed. Otherwise, there were no differences in terms of conversion, complications, or length of stay between both groups.

Conclusions

A RSSC with a real-time near-infrared fluorescent cholangiography can be performed safely. In addition, for selected patients with a low BMI, ICG could shorten the operative time during RSSC. Larger studies are still required before drawing definitive conclusions.

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Disclosures

Drs. Buchs, Pugin, Azagury, Volonte, Jung, and Morel have no conflicts of interest or financial ties to disclose. Dr. Hagen has a financial relationship with Intuitive Surgical.

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Authors and Affiliations

  1. Clinic for Visceral and Transplantation Surgery, Department of Surgery, Faculty of Medicine, University Hospital of Geneva, University of Geneva, Rue Gabriel-Perret-Gentil, 4, 1211, Geneva 14, Switzerland

    Nicolas C. Buchs, François Pugin, Dan E. Azagury, Minoa Jung, Francesco Volonte, Monika E. Hagen & Philippe Morel

Authors
  1. Nicolas C. Buchs
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  2. François Pugin
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  3. Dan E. Azagury
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  4. Minoa Jung
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  5. Francesco Volonte
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  6. Monika E. Hagen
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  7. Philippe Morel
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Corresponding author

Correspondence to Nicolas C. Buchs.

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Buchs, N.C., Pugin, F., Azagury, D.E. et al. Real-time near-infrared fluorescent cholangiography could shorten operative time during robotic single-site cholecystectomy. Surg Endosc 27, 3897–3901 (2013). https://doi.org/10.1007/s00464-013-3005-5

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  • DOI: https://doi.org/10.1007/s00464-013-3005-5

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