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Robotic multiport versus robotic single-site cholecystectomy: a retrospective single-centre experience of 142 cases

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Summary

Background

Robotic cholecystectomy with the da Vinci Xi® system (Intuitive Surgical, Sunnyvale, CA, USA) can be performed either as a multiport or a single-incision procedure with the da Vinci Single-Site® platform. The value of robotic single-site cholecystectomy is still under debate. The aim of this study was to compare perioperative measures and postoperative outcomes of both robotic assisted approaches.

Methods

142 patients with benign gallbladder disease underwent da Vinci multiport (DVMPC; n = 111) or da Vinci Single-Site® cholecystectomy (DVSSC; n = 31) in our institution between October 2015–December 2018. Patient demographics and characteristics, perioperative measures, complications and outcomes were retrospectively analysed.

Results

Patients with DVSSC had a significant lower BMI an were younger compared to DVMPC patients (BMI: 25.2 versus 28.1, p = 0.004; age: 44.5 versus 54.2 years, p = 0.007). Operative time was longer in the DVSSC group (84.9 versus 69.9 minutes, p = 0.007). In the DVSSC group there were significantly more superficial surgical site infections (16.6 versus 3.6%, p = 0.024), more overall complications according to Clavien-Dindo (29.0 versus 9.9%, p = 0.016), and more pain on postoperative day 3 (numeric rating scale, 1.3 versus 0.4, p = 0.026). In both groups there were no injuries of hepatic hilar structures such as the common bile duct or of the right hepatic artery.

Conclusions

DVSSC could be performed safely even in patients with acute cholecystitis and previous abdominal surgery. However, the da Vinci Single-Site® approach for cholecystectomy should not be considered as the standard of care procedure for benign gallbladder disease, due to a higher incidence of superficial surgical site infections, more overall complications and more postoperative pain compared to DVMPC.

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Authors and Affiliations

  1. Department of General, Visceral and Thoracic Surgery, German Armed Forces Hospital of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany

    Christian Beltzer, Katrin Gradinger, Hartmut Dippel & Roland Schmidt

  2. Department of General, Visceral and Transplant Surgery, University Hospital of Tübingen, Tübingen, Germany

    Robert Bachmann & Steffen Axt

Authors
  1. Christian Beltzer
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  2. Katrin Gradinger
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  3. Robert Bachmann
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  4. Steffen Axt
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  6. Roland Schmidt
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Correspondence to Christian Beltzer.

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Conflict of interest

C. Beltzer, K. Gradinger, R. Bachmann, S. Axt, H. Dippel and R. Schmidt declare that they have no competing interests.

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Beltzer, C., Gradinger, K., Bachmann, R. et al. Robotic multiport versus robotic single-site cholecystectomy: a retrospective single-centre experience of 142 cases. Eur Surg 52, 16–21 (2020). https://doi.org/10.1007/s10353-019-00619-x

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  • DOI: https://doi.org/10.1007/s10353-019-00619-x

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