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Comparison of short- and long-term postoperative occurrences after robotic single-incision cholecystectomy versus multiport laparoscopic cholecystectomy

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Abstract

Background

Long-term outcomes of SIRC are not well established. Furthermore, SIRC is only now being considered more frequently for patients with independent risk factors for PSH, such as obesity. As such, the paucity of data on longer-term post-surgical outcomes of SIRC is particularly notable as it pertains to obese patients.

Methods

All patients undergoing cholecystectomy performed by two surgeons at our institution from 2008–2018 were reviewed. Our inclusion criteria were patients who underwent SIRC or multiport laparoscopic cholecystectomy (MPLC) and had at least one month of postoperative follow-up. Patients who underwent additional procedures at the time of cholecystectomy were excluded. Our outcomes of interest were the 30-day POC rate and the long-term PSH rate. Analysis was conducted on an intention-to-treat basis, using logistic regression analysis for POC and time-to-event analysis for PSH.

Results

We examined 584 patients who underwent either SIRC (51%) or MPLC (49%). Of the 296 patients who underwent SIRC, 15 (5%) developed a POC and 23 (8%) developed a PSH. Of the 288 patients who underwent MPLC, 11 (4%) developed a POC, and 28 (10%) developed a PSH. Procedure group and obesity was not associated with the risk of POC (p = 0.29, p = 0.21, respectively). Procedure group was not associated with an increased risk of PSH (p = 0.29). Obese patients, however, were 1.94 times more likely to develop PSH compared to non-obese patients overall (p = 0.02).

Conclusions

There is no statistically significant difference in POC and PSH rate following SIRC when compared with MPLC in patients in the same BMI group. Male gender and prior abdominal surgery are risk factors for POC, while advancing age and obesity are risk factors for PSH.

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Abbreviations

SIRC:

Single-incision robotic cholecystectomy

MPLC:

Multiport laparoscopic cholecystectomy

MPRC:

Multiport robot-assisted cholecystectomy

SILC:

Single-incision laparoscopic cholecystectomy

POC:

Postoperative complication

PSH:

Port site hernia

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    Stuart A. Abel, Benzon M. Dy, Hind Al-Lami, Suhail A. Zeineddin, Abhishek Chandra, Juliane Bingener & Melanie L. Lyden

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  1. Stuart A. Abel
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  2. Benzon M. Dy
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  3. Hind Al-Lami
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  4. Suhail A. Zeineddin
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  5. Abhishek Chandra
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  6. Juliane Bingener
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  7. Melanie L. Lyden
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Corresponding author

Correspondence to Melanie L. Lyden.

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Disclosures

Stuart A. Abel, MD, Benzon M. Dy, MD, Hind Al-Lami MB ChB MPH, Suhail A. Zeineddin MD, Abhishek Chandra, Juliane Bingener MD FACS, and Melanie L. Lyden MD FACS have nothing to disclose and no conflicts of interest.

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Abel, S.A., Dy, B.M., Al-Lami, H. et al. Comparison of short- and long-term postoperative occurrences after robotic single-incision cholecystectomy versus multiport laparoscopic cholecystectomy. Surg Endosc 36, 2357–2364 (2022). https://doi.org/10.1007/s00464-021-08513-y

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