A Comparative Study of Outcomes Between Single-Site Robotic and Multi-port Laparoscopic Cholecystectomy: An Experience from a Tertiary Care Center
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.
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.
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).
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.
KeywordsChronic Obstructive Pulmonary Disease Laparoscopic Cholecystectomy Incisional Hernia Gallbladder Disease Total Operative Time
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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