Surgical Endoscopy

, Volume 27, Issue 10, pp 3897–3901

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

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

DOI: 10.1007/s00464-013-3005-5

Cite this article as:
Buchs, N.C., Pugin, F., Azagury, D.E. et al. Surg Endosc (2013) 27: 3897. doi:10.1007/s00464-013-3005-5

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.

Keywords

Indocyanine green Fluorescence Cholangiography Single-site Robotic Cholecystectomy Operative time 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Nicolas C. Buchs
    • 1
  • François Pugin
    • 1
  • Dan E. Azagury
    • 1
  • Minoa Jung
    • 1
  • Francesco Volonte
    • 1
  • Monika E. Hagen
    • 1
  • Philippe Morel
    • 1
  1. 1.Clinic for Visceral and Transplantation Surgery, Department of Surgery, Faculty of Medicine, University Hospital of GenevaUniversity of GenevaGeneva 14Switzerland

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