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Surgical Endoscopy

, Volume 32, Issue 12, pp 4716–4727 | Cite as

Safety of single-incision robotic cholecystectomy for benign gallbladder disease: a systematic review

  • Marco Migliore
  • Alberto ArezzoEmail author
  • Simone Arolfo
  • Roberto Passera
  • Mario Morino
Review Article

Abstract

Background

Multiport laparoscopic cholecystectomy (MLC) is the gold standard technique for cholecystectomy. In order to reduce postoperative pain and improve cosmetic results, the application of the single-incision laparoscopic cholecystectomy (SILC) technique was introduced, leading surgeons to face important challenges. Robotic technology has been proposed to overcome some of these limitations. The purpose of this review is to assess the safety of single-incision robotic cholecystectomy (SIRC) for benign disease.

Methods

An Embase and Pubmed literature search was performed in February 2017. Randomized controlled trial and prospective observational studies were selected and assessed using PRISMA recommendations. Primary outcome was overall postoperative complication rate. Secondary outcomes were postoperative bile leak rate, total conversion rate, operative time, wound complication rate, postoperative hospital stay, and port site hernia rate. The outcomes were analyzed in Forest plots based on fixed and random effects model. Heterogeneity was assessed using the I2 statistic.

Results

A total of 13 studies provided data about 1010 patients who underwent to SIRC for benign disease of gallbladder. Overall postoperative complications rate was 11.6% but only 4/1010 (0.4%) patients required further surgery. A postoperative bile leak was reported in 3/950 patients (0.3%). Conversion occurred in 4.2% of patients. Mean operative time was 86.7 min including an average of 42 min should be added as for robotic console time. Wound complications occurred in 3.7% of patients. Median postoperative hospital stay was 1 day. Port site hernia at the latest follow-up available was reported in 5.2% of patients.

Conclusions

The use of the Da Vinci robot in single-port cholecystectomy seems to have similar results in terms of incidence and grade of complications compared to standard laparoscopy. In addition, it seems affected by the same limitations of single-port surgery, consisting of an increased operative time and incidence of port site hernia.

Keywords

Robotic cholecystectomy Single site Minimally invasive surgical procedures Systematic review 

Notes

Funding

The authors declare that no funding support was received for this study.

Compliance with Ethical Standards

Disclosures

Drs Marco Migliore, Alberto Arezzo, Simone Arolfo, Roberto Passera, and Mario Morino have no conflicts of interest or financial ties to disclose.

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgical SciencesUniversity of TorinoTorinoItaly
  2. 2.Division of Nuclear MedicineUniversity of TorinoTorinoItaly

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