Abstract
This study aims to introduce an alternative technique for effective single-site robotic cholecystectomy (SSRC) using a reverse port. Proper exposure of Calot's triangle is critical for safe laparoscopic cholecystectomy. Current robotic surgical systems are useful for singlesite cholecystectomy. However, in exposing Calot's triangle, the gallbladder is usually retracted in a medial and upward direction, resulting in a narrow triangle. This intraoperative view is a major obstacle to safe laparoscopic cholecystectomy. From October 2013 to October 2014, 55 consecutive patients underwent SSRC by a single surgeon at Yonsei University Severance Hospital. Initially, 5 patients underwent the original robotic single site cholecystectomy technique, and the remaining 50 patients underwent robotic single site cholecystectomy using our reverse port technique. There were no differences between the SSRC-O (original port) group and the SSRC-R (reverse port) group in terms of patient age (P=0.244), body mass index (P=0.503), and pathologic conditions of the gallbladder (P=0.841). Total operation time (132.6 vs 99.12 min; P=0.009), actual dissection time (51.6 vs 30.28 min; P=0.001), and console time (84.4 vs 50.46 min; P=0.001) were all significantly shorter in the SSRC-R group. Mean intraoperative blood loss was minimal in both groups (20 vs 12.4 mL, P=0.467), and bile spillage occurred in 2 patients of the SSRC-R group. There was one case of laparoscopic conversion in the SSRC-R group. The reverse port technique described in this study successfully widened Calot's triangle and improved the safety of the current robotic surgical system for single-site robotic cholecystectomy.
| Original language | English |
|---|---|
| Pages (from-to) | e1871 |
| Journal | Medicine (United States) |
| Volume | 94 |
| Issue number | 42 |
| DOIs | |
| Publication status | Published - 2015 Oct 1 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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Single-site robotic cholecystectomy reverse-port technique. / Jung, Myung Jae; Lee, So Young; Lee, Sung Hwan; Kang, ChangMoo; Lee, Woo Jung.
In: Medicine (United States), Vol. 94, No. 42, 01.10.2015, p. e1871.Research output: Contribution to journal › Article
TY - JOUR
T1 - Single-site robotic cholecystectomy reverse-port technique
AU - Jung, Myung Jae
AU - Lee, So Young
AU - Lee, Sung Hwan
AU - Kang, ChangMoo
AU - Lee, Woo Jung
PY - 2015/10/1
Y1 - 2015/10/1
N2 - This study aims to introduce an alternative technique for effective single-site robotic cholecystectomy (SSRC) using a reverse port. Proper exposure of Calot's triangle is critical for safe laparoscopic cholecystectomy. Current robotic surgical systems are useful for singlesite cholecystectomy. However, in exposing Calot's triangle, the gallbladder is usually retracted in a medial and upward direction, resulting in a narrow triangle. This intraoperative view is a major obstacle to safe laparoscopic cholecystectomy. From October 2013 to October 2014, 55 consecutive patients underwent SSRC by a single surgeon at Yonsei University Severance Hospital. Initially, 5 patients underwent the original robotic single site cholecystectomy technique, and the remaining 50 patients underwent robotic single site cholecystectomy using our reverse port technique. There were no differences between the SSRC-O (original port) group and the SSRC-R (reverse port) group in terms of patient age (P=0.244), body mass index (P=0.503), and pathologic conditions of the gallbladder (P=0.841). Total operation time (132.6 vs 99.12 min; P=0.009), actual dissection time (51.6 vs 30.28 min; P=0.001), and console time (84.4 vs 50.46 min; P=0.001) were all significantly shorter in the SSRC-R group. Mean intraoperative blood loss was minimal in both groups (20 vs 12.4 mL, P=0.467), and bile spillage occurred in 2 patients of the SSRC-R group. There was one case of laparoscopic conversion in the SSRC-R group. The reverse port technique described in this study successfully widened Calot's triangle and improved the safety of the current robotic surgical system for single-site robotic cholecystectomy.
AB - This study aims to introduce an alternative technique for effective single-site robotic cholecystectomy (SSRC) using a reverse port. Proper exposure of Calot's triangle is critical for safe laparoscopic cholecystectomy. Current robotic surgical systems are useful for singlesite cholecystectomy. However, in exposing Calot's triangle, the gallbladder is usually retracted in a medial and upward direction, resulting in a narrow triangle. This intraoperative view is a major obstacle to safe laparoscopic cholecystectomy. From October 2013 to October 2014, 55 consecutive patients underwent SSRC by a single surgeon at Yonsei University Severance Hospital. Initially, 5 patients underwent the original robotic single site cholecystectomy technique, and the remaining 50 patients underwent robotic single site cholecystectomy using our reverse port technique. There were no differences between the SSRC-O (original port) group and the SSRC-R (reverse port) group in terms of patient age (P=0.244), body mass index (P=0.503), and pathologic conditions of the gallbladder (P=0.841). Total operation time (132.6 vs 99.12 min; P=0.009), actual dissection time (51.6 vs 30.28 min; P=0.001), and console time (84.4 vs 50.46 min; P=0.001) were all significantly shorter in the SSRC-R group. Mean intraoperative blood loss was minimal in both groups (20 vs 12.4 mL, P=0.467), and bile spillage occurred in 2 patients of the SSRC-R group. There was one case of laparoscopic conversion in the SSRC-R group. The reverse port technique described in this study successfully widened Calot's triangle and improved the safety of the current robotic surgical system for single-site robotic cholecystectomy.
UR - http://www.scopus.com/inward/record.url?scp=84948130948&partnerID=8YFLogxK
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U2 - 10.1097/MD.0000000000001871
DO - 10.1097/MD.0000000000001871
M3 - Article
VL - 94
SP - e1871
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 42
ER -