Cholecystectomy using a novel Single-SiteA® robotic platform: early experience from 45 consecutive cases

The aim of this work was to study the feasibility, safety, and efficacy of single-incision robotic cholecystectomy using a novel platform from Intuitive Surgical. All operations were performed by the same surgeon. Parameters assessed included patient history, indication for surgery, operation time, complication rate, conversion rate, robot-related issues, length of hospital stay, postoperative pain, and time to return to work. All patients were followed for a 2-month period postoperatively. Forty-five patients (22 women, 23 men) underwent single-incision robotic cholecystectomy from March 1 to July 15, 2011. There were no conversions to either conventional laparoscopy or laparotomy, although in three cases a second trocar was used. There were no major complications apart from a single case of postoperative hemorrhage. Average patient age was 47 +/- A 12 years (range = 27-80 years) and average BMI was 30 kg/m(2) (mean = 28.8 +/- A 4 kg/m(2), range = 18.4-46.7 kg/m(2)). The primary indication for surgery was gallstones. The mean operation time (skin-to-skin) was 84.5 +/- A 25.5 min (range = 51-175 min), docking time was 5.8 +/- A 1.5 min (range = 4-11 min), and console time (net surgical time) was 43 +/- A 21.9 min (range = 21-121 min). Intraoperative blood loss was negligible. There were no collisions between the robotic arms and no other robot-related problems. Average postoperative length of stay was less than 24 h. The mean Visual Analog Pain Scale Score 6 h after the operation was 2.2 +/- A 1.51 (range = 0-6) and patients returned to normal activities in 4.48 +/- A 2.3 days (range = 1-9 days). Single-Site(A (R)) is a new platform offering a potentially more stable and reliable environment to perform single-port cholecystectomy. Both simple and complicated cholecystectomies can be performed with safety. The technique is possible in patients with a high BMI. The induction of pneumoperitoneum using the new port and the docking process require additional training.