Abstract
Background and aims
Laparoscopic surgery has become the treatment of choice for cholecystectomy. Many studies showed that while this approach benefits the patient, the surgeon faces such distinct disadvantages as a poor ergonomic situation and limited degrees of freedom with limited motion as a consequence. Robots have the potential to overcome these problems. To evaluate the efficiency and feasibility of robotically assisted surgery (RAC), we designed a prospective study to compare it with standard laparoscopic cholecystectomy (SLC).
Materials and methods
Between 2001 and 2003, 26 patients underwent SLC and 20 patients underwent RAC using the ZEUS system. The feasibility, safety, and possible advantages were evaluated. To assess the efficacy, the total time in the operating room was divided into preoperative, operative, and postoperative time frames.
Results
For RAC in comparison with SLC, the preoperative phase including equipment setup was significantly longer. In the intraoperative phase, the cut-closure time and camera and trocar insertion times were significantly longer. It is interesting to note that the net dissection time for the cystic artery, duct, and the gall bladder was not different from SLC.
Conclusions
The study demonstrates the feasibility of robotically assisted cholecystectomy without system-specific morbidity. There is time loss in several phases of robotic surgery due to equipment setup and deinstallation and therefore, presents no benefit in using the robot in laparoscopic cholecystectomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Williams LF, Chapman WC, Bonau RA et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465
Allendorf JD, Bessler M, Whelan RL et al (1997) Postoperative immune function varies inversely with the degree of surgical trauma in a murine model. Surg Endosc 11:427–430
Heikkinen TJ, Haukipuro K, Bringman S et al (2000) Comparison of laparoscopic and open Nissen fundoplication 2 years after operation: a prospective randomized trial. Surg Endosc 14:1019–1023
Himpens J, Leman G, Cadier GB (1998) Telesurgical laparoscopic cholecystectomy (letter). Surg Endosc 12:1091
Cecconi S, Coratti A, Angelini M et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465
Chapman WHH, Albrecht RJ, Kim VB et al (2001) Computer enhanced robotically assisted telemanipulative cholecystectomy (abstract). Surg Endosc 15:S114
Jacobsen G, Elli F, Horgau S (2004) Robotic surgery update. Surg Endosc 18:1186–1191
Gutt CN, Oniu T, Mehrabi A et al (2004) Robot-assisted abdominal surgery. Br J Surg 91:1390–1397
Hance J, Rockall T, Darzi A (2004) Robotics in colorectal surgery. Dig Surg 21:339–343
Ruurda JP, Visser PL, Broeders IAMJ (2003) Analysis of procedure time in robot-assisted surgery: comparative study in laparoscopic cholecystectomy. Comput Aided Surg 8:24–29
Nio D, Bemelman WA, den Boer KT et al (2002) Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in performance of standardized tasks. Surg Endosc 16:412–415
Prasad SM, Maniar HS, Soper NJ et al (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183:702–707
Sung GT, Gill IS, Hsu TH (1999) Robotic assisted laparoscopic pyeloplasty: a pilot study. Urology 53:1099–1103
Garcia-Ruiz A, Gagner M, Miller JF et al (1998) Manual versus robotically assisted laparoscopic surgery in the performance of basic manipulation and suturing task. Arch Surg 133:957–961
Chitwood WR, Nifong LW, Chapman WHH et al (2001) Robotic surgical training in an academic institution. Ann Surg 234:475–486
Kim VB, Chapman WHM, Albrecht RJ et al (2002) Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using Da Vinci. Surg Laparosc Endosc Percutan Tech 12:33–40
White P, Carbajal-Ramos A, Gracia C et al (2003) A prospective randomized study of the ZEUS robotic surgical system for laparoscopic cholecystectomy. In: Proceedings of the SAGES 2003 meeting, Los Angeles, CA, March 12–15. Surg Endosc 17:S061–S089
Marescaux J, Smith MK, Fölscher D et al (2001) Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 234:1–7
Mischinger HJ, Rigler MY, Werkgartner G (2001) Erste klinische Erfahrungen mit dem Einsatz der Robotertechnik in der Viszeralchirurgie. Acta Chir Austriaca 33(Suppl 175):57
Marescaux J, Rubino F (2005) Robotic surgery: potentials, barriers, and limitations. Eur Surg 37/5:279–283
Meir AH, Rawn CL, Krummel TM (2001) Virtual reality: surgical application—challenge for the new millenium. J Am Coll Surg 192:372–384
Perrisat J (1993) Laparoscopic cholecystectomy: the European experience. Am J Surg 165:444–449
Gadacz TR (2000) Update on laparoscopic cholecystectomy, including a clinical pathway. Surg Clin North Am 80:1127–1149
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kornprat, P., Werkgartner, G., Cerwenka, H. et al. Prospective study comparing standard and robotically assisted laparoscopic cholecystectomy. Langenbecks Arch Surg 391, 216–221 (2006). https://doi.org/10.1007/s00423-006-0046-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-006-0046-4