The First Experiences of Robotic Single-Site Cholecystectomy in Asia: A Potential Way to Expand Minimally-Invasive Single-Site Surgery?
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Purpose: Herein, we firstly present the robotic single-site cholecystectomy (RSSC) as performed in Asia and evaluate whether it could overcome the limitations of conventionallaparoscopic single-site cholecystectomy. Materials and Methods: From October 2013 to November 2013, RSSC for benign gallbladder (GB) disease was firstly performed consecutively in five patients. We evaluated these early experiences of RSSC and compared factors including clinicopathologic factors and operative outcomeswith our initial cases of single-fulcrum laparoscopic cholecystectomy (SFLC). Results: Four female patients and one male patient underwent RSSC. Neither open conversion nor bile duct injury or bile spillage was noted during surgery. In comparisonswith SFLC, patient-related factors in terms of age, sex, Body Mass Index, diagnosis,and American Society of Anesthesiologist score showed no significant differencesbetween two groups. There were no significant differences in the operative outcomes regarding intraoperative blood loss, bile spillage during operation, postoperativepain scale values, postoperative complications, and hospital stay between the two groups (p<0.05). Actual dissection time (p=0.003) and total operation time (p=0.001) were significantly longer in RSSC than in SFLC. There were no drain insertionor open conversion cases in either group. Conclusion: RSSC provides a comfortableenvironment and improved ergonomics to laparoscopic single-site cholecystectomy;however, this technique needs to be modified to allow for more effective intracorporeal movement. As experience and technical innovations continue, RSSC will soon be alternative procedure for well-selected benign GB disease.
Abstract
Purpose: Herein, we firstly present the robotic single-site cholecystectomy (RSSC) as performed in Asia and evaluate whether it could overcome the limitations of conventionallaparoscopic single-site cholecystectomy. Materials and Methods: From October 2013 to November 2013, RSSC for benign gallbladder (GB) disease was firstly performed consecutively in five patients. We evaluated these early experiences of RSSC and compared factors including clinicopathologic factors and operative outcomeswith our initial cases of single-fulcrum laparoscopic cholecystectomy (SFLC). Results: Four female patients and one male patient underwent RSSC. Neither open conversion nor bile duct injury or bile spillage was noted during surgery. In comparisonswith SFLC, patient-related factors in terms of age, sex, Body Mass Index, diagnosis,and American Society of Anesthesiologist score showed no significant differencesbetween two groups. There were no significant differences in the operative outcomes regarding intraoperative blood loss, bile spillage during operation, postoperativepain scale values, postoperative complications, and hospital stay between the two groups (p<0.05). Actual dissection time (p=0.003) and total operation time (p=0.001) were significantly longer in RSSC than in SFLC. There were no drain insertionor open conversion cases in either group. Conclusion: RSSC provides a comfortableenvironment and improved ergonomics to laparoscopic single-site cholecystectomy;however, this technique needs to be modified to allow for more effective intracorporeal movement. As experience and technical innovations continue, RSSC will soon be alternative procedure for well-selected benign GB disease.
참고문헌 (17)
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