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True single-port cholecystectomy with ICG cholangiography through a single 15-mm trocar using the new surgical platform “symphonX”: first human case study with a commercially available device

  • 2019 EAES Oral
  • Published:
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Abstract

Background

Minimally invasive single-port surgery is often associated with large incisions up to 2–3 cm, complicated handling due to the lack of triangulation, and instrument crossing. Aim of this prospective study was to perform true single-port surgery (cholecystectomy) without the use of assisting trocars using a new surgical platform that allows for triangulation incorporating robotic features, and to measure the perioperative outcome and cosmetic results.

Methods

As the first European site after FDA and CE-mark approval, the new device has been introduced to our academic center. In patients with cholecystitis and cholecystolithiasis, the operation was performed through only one 15-mm trocar. For patients safety, intraoperative cholangiography using intravenous ICG and a standard Stryker 1588 system was routinely performed.

Results

Symphonx was used in n = 12 patients for abdominal surgery (6 females, mean age 42.5 [30–77], mean BMI 26.2 [19.3–38.9]. A total of 8 patients underwent surgery using no additional ports besides the 15-mm trocar; in the remaining patients, one assisting instrument (3–5 mm) was used. Mean OR time was 107 [72–221] minutes. The postoperative course was uneventful in 11 patients; in one patient, a seroma at the surgical site required interventional drainage 1 month postoperatively. No intraoperative complications occurred.

Conclusion

This is the first human case series using the commercially available symphonX platform for abdominal laparoscopic surgery and the first series using the system without assisting instruments. Laparoscopic cholecystectomy in patients with cholecystitis and cholecystolithiasis using the symphonX platform through only one 15-mm trocar is feasible, safe, and more cost-efficient compared to robotic platforms.

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Funding

Funding

This study was made possible by funding support received from Fortimedix Surgical B.V. (educational grant).

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Author notes

  1. Rabi R. Datta and Georg Dieplinger have contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, University of Cologne, Kerpener Str. 62, Cologne, 50937, Germany

    Rabi R. Datta, Georg Dieplinger, Roger Wahba, Robert Kleinert, Michael Thomas, Florian Gebauer, Lars Schiffmann, Dirk L. Stippel, Christiane J. Bruns & Hans F. Fuchs

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  1. Rabi R. Datta
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Correspondence to Hans F. Fuchs.

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Disclosures

This study was made possible by funding support received from Fortimedix Surgical B.V. Dr. Hans F. Fuchs is an investigator for Fortimedix Surgical. BV. Drs. Datta, Dieplinger, Wahba, Kleinert, Thomas, Gebauer, Schiffmann, Stippel, and Bruns have no conflicts of interest or financial ties to disclose.

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Datta, R.R., Dieplinger, G., Wahba, R. et al. True single-port cholecystectomy with ICG cholangiography through a single 15-mm trocar using the new surgical platform “symphonX”: first human case study with a commercially available device. Surg Endosc 34, 2722–2729 (2020). https://doi.org/10.1007/s00464-019-07229-4

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