Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 16, 2022; 14(12): 769-776
Published online Dec 16, 2022. doi: 10.4253/wjge.v14.i12.769
Our initial single port robotic cholecystectomy experience: A feasible and safe option for benign gallbladder diseases
Huseyin Kemal Rasa, Ayhan Erdemir
Huseyin Kemal Rasa, Ayhan Erdemir, Department of General Surgery, Anadolu Medical Center Hospital, Kocaeli 41400, Turkey
Author contributions: Rasa HK contributed to conceptualization of the study, methodology, writing, review and editing of the manuscript, and project administration; Erdemir A contributed to conceptualization of the study, methodology, formal analysis of the data, investigation into the literature and writing of the original draft of the manuscript; both authors read and approved the final manuscript.
Institutional review board statement: The study was conducted following the Declaration of Helsinki (as revised in 2013) and was approved by Anadolu Medical Center Hospital review board and ethics committee (ASM-EK-22/186).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: The datasets analyzed during the current study are available in the hospital’s “electronic patient records” and from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huseyin Kemal Rasa, MD, Attending Doctor, Department of General Surgery, Anadolu Medical Center Hospital, Cumhuriyet Mahallesi 2255 Sokak No 3 Gebze, Kocaeli 41400, Turkey. kemrasa@gmail.com
Received: September 22, 2022
Peer-review started: September 22, 2022
First decision: October 20, 2022
Revised: November 25, 2022
Accepted: December 1, 2022
Article in press: December 1, 2022
Published online: December 16, 2022
Processing time: 82 Days and 15.9 Hours
ARTICLE HIGHLIGHTS
Research background

Single-port laparoscopic cholecystectomy has been performed for over 25 years but is not popular. The narrow working space in this surgery limits the movement of instruments and causes ergonomic challenges. Robotic surgery resolves the ergonomic challenges. However, the extent to which these technical and ergonomic advantages positively affect the surgical outcomes and the safety of the single-port robotic surgeries need to be assessed.

Research motivation

Our first motivation for the study was to determine the feasibility and safety of single-port laparoscopic cholecystectomy. We also evaluated patient outcomes after robotic surgery.

Research objectives

Our main objective was to evaluate the safety of single-port laparoscopic cholecystectomy by determining intraoperative blood loss, conversion rate, and risk of bile duct injury or postoperative bile leak. We also determined the necessity of grafts during fascia closure.

Research methods

Our research methodology was retrospective electronic patient record evaluation.

Research results

We observed that the mean blood loss during the operation was 58.4 mL, and drain placement was required in 12 patients (30.0%). The median operative time was 93.5 min. We hypothesize that experience of the surgeon will have a positive effect on those numbers, and future studies will have better results. After port removal, graft reinforcement for fascia closure was preferred in 14 patients (35.0%). One patient was readmitted to the hospital due to pain (2.5%). Clavien-Dindo I complications were seen in 14 patients (35.0%), and 5 complications (12.5%) were wound site problems. These data support the safety of single-port robotic cholecystectomy.

Research conclusions

The findings of this study, which we performed on 40 consecutive patients, strongly supported the view that single-port robotic cholecystectomy is a feasible and safe surgery. Considering the technological and ergonomic advantages it provides to the surgeon, single-port robotic cholecystectomy seems an excellent option that should be considered for all benign gallbladder pathologies.

Research perspectives

It would be appropriate to confirm our results with randomized controlled studies to be conducted with more patients in the near future. Also, comparing single-port laparoscopic cholecystectomy and single-port robotic cholecystectomy will be helpful.