Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): Comparison of learning curves. First European experience

Giuseppe Spinoglio, Luca Matteo Lenti, Valeria Maglione, Francesco Saverio Lucido, Fabio Priora, Paolo Pietro Bianchi, Federica Grosso, Raul Quarati

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background Single-incision laparoscopic surgery is an emerging procedure developed to decrease parietal trauma and improve cosmetic results. However, many technical constraints, such as lack of triangulation, instrument collisions, and cross-handing, hamper this approach. Using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. Methods We retrospectively collected, under institutional review board approval, data on the first 25 patients who underwent single-site robotic cholecystectomies (SSRC) at our center. Patients enrolled in this study underwent SSRC for symptomatic biliary gallstones or polyposis. Exclusion criteria were: BMI>33; acute cholecystitis; previous upper abdominal surgery; ASA>II; and age>80 and\18 years. All procedures were performed with the da Vinci Si Surgical System̊ and a dedicated SSRC kit (Intuitive̊). After discharge, patients were followed for 2 months. These SSRC cases were compared to our first 25 single-incision laparoscopic cholecystectomies (SILC) and with the literature. Results There were no differences in patient characteristics between groups (gender, P = 0.4404; age, P = 0.7423; BMI, P = 0.5699), and there were no conversions or major complications in either cohort. Operative time was significantly longer for the SILC group compared with SSRC (83.2 vs. 62.7 min, P = 0.0006), and SSRC operative times did not change significantly along the series. The majority of patients in each group were discharged within 24 h, with an average length of hospital stay of 1.2 days for the SILC group and 1.1 days for the SSRC group (P = 0.2854). No wound complications (infection, incisional hernia) were observed in the SSRC group and in the SILC. Conclusions Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC.

Original languageEnglish
Pages (from-to)1648-1655
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume26
Issue number6
DOIs
Publication statusPublished - Jun 2012

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Learning Curve
Laparoscopic Cholecystectomy
Robotics
Cholecystectomy
Operative Time
Length of Stay
Acute Cholecystitis
Research Ethics Committees
Gallstones
Wound Infection
Cosmetics
Laparoscopy

Keywords

  • Minimally invasive surgery
  • Robotic surgery
  • Single-incision laparoscopic surgery
  • Single-site robotic cholecystectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC) : Comparison of learning curves. First European experience. / Spinoglio, Giuseppe; Lenti, Luca Matteo; Maglione, Valeria; Lucido, Francesco Saverio; Priora, Fabio; Bianchi, Paolo Pietro; Grosso, Federica; Quarati, Raul.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 26, No. 6, 06.2012, p. 1648-1655.

Research output: Contribution to journalArticle

Spinoglio, Giuseppe ; Lenti, Luca Matteo ; Maglione, Valeria ; Lucido, Francesco Saverio ; Priora, Fabio ; Bianchi, Paolo Pietro ; Grosso, Federica ; Quarati, Raul. / Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC) : Comparison of learning curves. First European experience. In: Surgical Endoscopy and Other Interventional Techniques. 2012 ; Vol. 26, No. 6. pp. 1648-1655.
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abstract = "Background Single-incision laparoscopic surgery is an emerging procedure developed to decrease parietal trauma and improve cosmetic results. However, many technical constraints, such as lack of triangulation, instrument collisions, and cross-handing, hamper this approach. Using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. Methods We retrospectively collected, under institutional review board approval, data on the first 25 patients who underwent single-site robotic cholecystectomies (SSRC) at our center. Patients enrolled in this study underwent SSRC for symptomatic biliary gallstones or polyposis. Exclusion criteria were: BMI>33; acute cholecystitis; previous upper abdominal surgery; ASA>II; and age>80 and\18 years. All procedures were performed with the da Vinci Si Surgical System̊ and a dedicated SSRC kit (Intuitive̊). After discharge, patients were followed for 2 months. These SSRC cases were compared to our first 25 single-incision laparoscopic cholecystectomies (SILC) and with the literature. Results There were no differences in patient characteristics between groups (gender, P = 0.4404; age, P = 0.7423; BMI, P = 0.5699), and there were no conversions or major complications in either cohort. Operative time was significantly longer for the SILC group compared with SSRC (83.2 vs. 62.7 min, P = 0.0006), and SSRC operative times did not change significantly along the series. The majority of patients in each group were discharged within 24 h, with an average length of hospital stay of 1.2 days for the SILC group and 1.1 days for the SSRC group (P = 0.2854). No wound complications (infection, incisional hernia) were observed in the SSRC group and in the SILC. Conclusions Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC.",
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author = "Giuseppe Spinoglio and Lenti, {Luca Matteo} and Valeria Maglione and Lucido, {Francesco Saverio} and Fabio Priora and Bianchi, {Paolo Pietro} and Federica Grosso and Raul Quarati",
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T1 - Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC)

T2 - Comparison of learning curves. First European experience

AU - Spinoglio, Giuseppe

AU - Lenti, Luca Matteo

AU - Maglione, Valeria

AU - Lucido, Francesco Saverio

AU - Priora, Fabio

AU - Bianchi, Paolo Pietro

AU - Grosso, Federica

AU - Quarati, Raul

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N2 - Background Single-incision laparoscopic surgery is an emerging procedure developed to decrease parietal trauma and improve cosmetic results. However, many technical constraints, such as lack of triangulation, instrument collisions, and cross-handing, hamper this approach. Using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. Methods We retrospectively collected, under institutional review board approval, data on the first 25 patients who underwent single-site robotic cholecystectomies (SSRC) at our center. Patients enrolled in this study underwent SSRC for symptomatic biliary gallstones or polyposis. Exclusion criteria were: BMI>33; acute cholecystitis; previous upper abdominal surgery; ASA>II; and age>80 and\18 years. All procedures were performed with the da Vinci Si Surgical System̊ and a dedicated SSRC kit (Intuitive̊). After discharge, patients were followed for 2 months. These SSRC cases were compared to our first 25 single-incision laparoscopic cholecystectomies (SILC) and with the literature. Results There were no differences in patient characteristics between groups (gender, P = 0.4404; age, P = 0.7423; BMI, P = 0.5699), and there were no conversions or major complications in either cohort. Operative time was significantly longer for the SILC group compared with SSRC (83.2 vs. 62.7 min, P = 0.0006), and SSRC operative times did not change significantly along the series. The majority of patients in each group were discharged within 24 h, with an average length of hospital stay of 1.2 days for the SILC group and 1.1 days for the SSRC group (P = 0.2854). No wound complications (infection, incisional hernia) were observed in the SSRC group and in the SILC. Conclusions Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC.

AB - Background Single-incision laparoscopic surgery is an emerging procedure developed to decrease parietal trauma and improve cosmetic results. However, many technical constraints, such as lack of triangulation, instrument collisions, and cross-handing, hamper this approach. Using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. Methods We retrospectively collected, under institutional review board approval, data on the first 25 patients who underwent single-site robotic cholecystectomies (SSRC) at our center. Patients enrolled in this study underwent SSRC for symptomatic biliary gallstones or polyposis. Exclusion criteria were: BMI>33; acute cholecystitis; previous upper abdominal surgery; ASA>II; and age>80 and\18 years. All procedures were performed with the da Vinci Si Surgical System̊ and a dedicated SSRC kit (Intuitive̊). After discharge, patients were followed for 2 months. These SSRC cases were compared to our first 25 single-incision laparoscopic cholecystectomies (SILC) and with the literature. Results There were no differences in patient characteristics between groups (gender, P = 0.4404; age, P = 0.7423; BMI, P = 0.5699), and there were no conversions or major complications in either cohort. Operative time was significantly longer for the SILC group compared with SSRC (83.2 vs. 62.7 min, P = 0.0006), and SSRC operative times did not change significantly along the series. The majority of patients in each group were discharged within 24 h, with an average length of hospital stay of 1.2 days for the SILC group and 1.1 days for the SSRC group (P = 0.2854). No wound complications (infection, incisional hernia) were observed in the SSRC group and in the SILC. Conclusions Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC.

KW - Minimally invasive surgery

KW - Robotic surgery

KW - Single-incision laparoscopic surgery

KW - Single-site robotic cholecystectomy

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