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World Journal of Surgery

, Volume 41, Issue 5, pp 1246–1253 | Cite as

A Comparative Study of Outcomes Between Single-Site Robotic and Multi-port Laparoscopic Cholecystectomy: An Experience from a Tertiary Care Center

  • Banujan Balachandran
  • Theadore A. Hufford
  • Taha Mustafa
  • Kunal Kochar
  • Suela Sulo
  • Joubin Khorsand
Original Scientific Report

Abstract

Background

The aim of this study was to compare the outcomes of single-site robotic cholecystectomy with multi-port laparoscopic cholecystectomy within a high-volume tertiary health care center.

Methods

A retrospective analysis of prospectively maintained data was conducted on patients undergoing single-site robotic cholecystectomy or multi-port laparoscopic cholecystectomy between October 2011 and July 2014. A single surgeon performed all the surgeries included in the study.

Results

A total of 678 cholecystectomies were performed. Of these, 415 (61%) were single-site robotic cholecystectomies and 263 (39%) were multi-port laparoscopic cholecystectomies. Laparoscopic patients had a greater mean BMI (30.5 vs. 29.0 kg/m2; p = 0.008), were more likely to have undergone prior abdominal surgery (83.3 vs. 41.4%; p < 0.001) and had a higher incidence of preexisting comorbidities (76.1 vs. 67.2%; p = 0.014) as compared to the robotic group. There was no statistical difference in the total operative time, rate of conversion to open procedure and mean length of follow-up between the two groups. The mean length of hospital stay was shorter for patients within the robotic group (1.9 vs. 2.4 days; p = 0.012). Single-site robotic cholecystectomy was associated with a higher rate of wound infection (3.9 vs. 1.1%; p = 0.037) and incisional hernia (6.5 vs. 1.9%; p = 0.006).

Conclusion

Multi-port laparoscopic cholecystectomy should remain the gold standard therapy for gallbladder disease. Single-site robotic cholecystectomy is an effective alternative procedure for uncomplicated benign gallbladder disease in properly selected patients. This must be carefully balanced against a high rate of surgical site infection and incisional hernia, and patients should be informed of these risks.

Keywords

Chronic Obstructive Pulmonary Disease Laparoscopic Cholecystectomy Incisional Hernia Gallbladder Disease Total Operative Time 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors would like to acknowledge Dr. John J. Park MD, Associate Program Director of Minimally Invasive Colon and Rectal Surgery Fellowship at Advocate Lutheran General Hospital for editing the manuscript and his mentorship throughout the study. We would also like to thank the efforts of Mrs. Olympia Katsabanis for her logistical support throughout the data collection and manuscript preparation process.

Compliance with ethical standards

Conflict of interest

Mr. Balachandran, Dr. Hufford, Dr. Mustafa, Dr. Kochar, Dr. Sulo and Dr. Khorsand have no conflicts of interest or financial ties to disclose.

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Banujan Balachandran
    • 1
  • Theadore A. Hufford
    • 2
  • Taha Mustafa
    • 1
  • Kunal Kochar
    • 1
  • Suela Sulo
    • 3
  • Joubin Khorsand
    • 4
  1. 1.Division of Colon and Rectal SurgeryAdvocate Lutheran General HospitalPark RidgeUSA
  2. 2.University of Illinois Metropolitan Group General Surgery ResidencyAdvocate Lutheran General HospitalPark RidgeUSA
  3. 3.Russell Institute for Research and InnovationAdvocate Lutheran General HospitalPark RidgeUSA
  4. 4.Division of General SurgeryAdvocate Lutheran General HospitalPark RidgeUSA

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