Advertisement

Surgical Endoscopy

, Volume 30, Issue 6, pp 2276–2280 | Cite as

A comparison of robotic single-incision and traditional single-incision laparoscopic cholecystectomy

  • Monica Gustafson
  • Tariq Lescouflair
  • Randall Kimball
  • Ibrahim Daoud
Article

Abstract

Background

Surgeons continually strive to improve technology and patient care. One remarkable demonstration of this is the development of laparoscopic surgery. Once this proved to be a safe and reliable surgical approach, robotics seemed a logical progression of surgical technology. The aim of this project was to evaluate the utility of robotics in the context of single-incision laparoscopic cholecystectomy (SILC).

Methods

A retrospective review of a prospectively maintained database of robotic single-incision laparoscopic cholecystectomy (RSILC) and traditional SILC performed by a single surgeon at our institution from July 2010 to August 2013 was queried. All consecutive patients undergoing RSILC and SILC during this time period were included. Primary outcomes include conversion rate and operative time. Secondary outcomes include length of stay, duration of narcotic use, time to independent performance of daily activities and cost. Categorical variables were evaluated using Chi-square analysis and continuous variables using t test or Wilcoxon’s rank test.

Results

Thirty-eight patients underwent RSILC and 44 underwent SILC. BMI was higher in the RSILC group, and the number of patients with prior abdominal surgeries was higher in the SILC group. Otherwise, demographics were similar between the two groups. There was no difference in conversion rate between RSILC and SILC (8 vs 11 %, p = 0.60). Mean operative time for RSILC was significantly greater compared with SILC (98 vs 68 min, p < 0.0001). RSILC was associated with a longer duration of narcotic use (2.3 vs 1.7 days, p = 0.0019) and time to independent performance of daily activities (4 vs 2.3 days, p < 0.0001). Total cost is greater in RSILC ($8961 vs $5379, p < 0.0001).

Conclusion

While RSILC can be safely performed, it is associated with longer operative times and greater cost.

Keywords

Cholecystectomy Human Robotic Technical Costs 

Notes

Acknowledgments

Dorothy Wakefield, MS, graciously assisted with statistical analysis.

Disclosures

Drs. Monica Gustafson, Tariq Lescouflair, Randall Kimball and Ibrahim Daoud, have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Roberts KE, Solomon D, Duffy AJ, Bell RL (2010) Sincle-incision laparoscopic cholecystectomy: a surgeon’s initial experience with 56 consecutive cases and a review of the literature. J Gastrointest Surg 14:506–510CrossRefPubMedGoogle Scholar
  2. 2.
    Gangl O, Hofer W, Tomaselli F, Sautner T, Függer R (2011) Single-incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC): a matched-pair analysis. Langenbecks Arch Surg 396:819–824CrossRefPubMedGoogle Scholar
  3. 3.
    Joseph S, Moore BT, Sorensen GB, Earley JW, Tang F, Jones P, Brown KM (2011) Single-incision laparoscopic cholecystectomy: a comparison with the gold standard. Surg Endosc 25:3008–3015CrossRefPubMedGoogle Scholar
  4. 4.
    Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G, Gecelter G, Rubach E, Rivas H, Islam A, Soper N, Paraskeva P, Rosemurgy A, Ross S, Shah S (2013) Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 216:1037–1048CrossRefPubMedGoogle Scholar
  5. 5.
    Aprea G, Coppola BE, Guida F, Masone S, Persico G (2011) Laparoendoscopic single-site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study. J Surg Res 166:109–112CrossRefGoogle Scholar
  6. 6.
    Bucher P, Pugin F, Buchs NC, Ostermann S, Morel P (2011) Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg 98:1695–1702CrossRefPubMedGoogle Scholar
  7. 7.
    Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terosu G, Sistu MA, Pasetto A (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg 165:29–34CrossRefPubMedGoogle Scholar
  8. 8.
    Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled study. Surg Endosc 24:1842–1848CrossRefPubMedGoogle Scholar
  9. 9.
    Liric MM, Califano AD, Angelini P, Corcione F (2011) Laparoendoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. Am J Surg 202:45–52CrossRefGoogle Scholar
  10. 10.
    Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel Single-Site® robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694CrossRefPubMedGoogle Scholar
  11. 11.
    Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J, Chalikonda S (2011) First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci Single-Site platform. Surg Endosc 25:3566–3573CrossRefPubMedGoogle Scholar
  12. 12.
    Spinoglio G, Lenti LM, Maglione V, Lucido FS, Priora F, Bianchi PP, Grosso F, Quarati R (2012) Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience. Surg Endosc 26:1648–1655CrossRefPubMedGoogle Scholar
  13. 13.
    Wren SM, Curet MJ (2011) Single-port robotic cholecystectomy. Results from a First human use clinical study of the new da Vinci single-site surgical platform. Arch Surg 146:1122–1127CrossRefPubMedGoogle Scholar
  14. 14.
    Gonzalez AM, Rabaza JR, Donkor C, Romero RJ, Kosanovic R, Verdeja JC (2013) Single-incision cholecystectomy: a comparative study of standard laparoscopic, robotic, and SPIDER platforms. Surg Endosc. doi: 10.1007/s00464-013-3105-2 Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Monica Gustafson
    • 1
  • Tariq Lescouflair
    • 2
  • Randall Kimball
    • 3
  • Ibrahim Daoud
    • 1
  1. 1.Department of Minimally Invasive SurgerySaint Francis Hospital and Medical CenterHartfordUSA
  2. 2.Department of SurgeryUniversity of Connecticut Health CenterFarmingtonUSA
  3. 3.Saratoga Center for General and Minimally Invasive SurgerySaratoga SpringsUSA

Personalised recommendations