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Single Site robotic Cholecystectomy: experience after 36 cases.
San Pio X Hospital, Milan – Italy
Jacques Mégevand, MD
May 2013 May 2015
SSRC: Single Site Robotic Cholecystectomy
36consecutive patients were operated on with Single
Site (DaVinci Si) for gallstones.
Our Early Experience
First 2 caseswere tutored by an expert surgeon in Robotic Surgery
(G. Spinoglio, MD).
We performed all procedures with the same team because of the importance of coordination between the surgeon and the assistants.
SSRC
Our Early Experience
36 ptsWomen 22 pts (61%)Men 14 pts (39%)
Mean Age 53 yy (range 21 – 77 yy)
Patients characteristics
SSRC
Operative Time
Mean total operative time (TOT)
77 minutes (range 55-150 minutes)
Mean robotic time (RT)
48 minutes (range 20-70 minutes)
Mean docking time: (including port placement, patients positioning, and docking of patient cart)
15 minutes (range 10-30 minutes)
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Conversion rate
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Conversion to Open 1/36 (2.7%)Severe intraoperative
complications (Acute cystic arthery
bleeding)
Conversion to Laparoscopy 2/36 (5.5%) Chronic cholecystitis
Clinical outcomeHospital stay
All patients were discharged 2 days after procedure, except the two patients who underwent laparotomic conversion.
Morbidity
Wound infection 2.7 % (1/36)
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Restricted lateral, upper and lower movements (close link with the camera)
Limitations for instruments (Hook, endowrist, absence of bipolar forceps,…...)
Careful dissection of the hilum for Hem-o-Lock placement
Conclusion
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Feasible with an accurate patient’s selection
Cosmetic outcome
ICG NIR-Fluorescence imaging
Conclusion
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Extension of surgical indications
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Conclusion
Right colectomiesLeft colectomies
Low anterior resectionHiatal ernia repair
Extension of surgical indications
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Conclusion
Right colectomiesLeft colectomies
Low anterior resectionHiatal ernia repair