Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea.
JSLS. 2022 Apr-Jun;26(2). doi: 10.4293/JSLS.2021.00091.
Single-incision laparoscopic cholecystectomy, first introduced in 1995, features acceptable cosmetic outcomes and postoperative pain control. The outcomes of single-port cholecystectomy by laparoscopy and robots were recently examined in many studies owing to surgeon and patient preference for minimally invasive surgery. A next-level da Vinci robotic platform was recently released. This study aimed to evaluate the feasibility and efficacy of robotic cholecystectomy (RC) using the da Vinci SP® system.
In this retrospective observational single-center study, we analyzed the medical records of 304 patients who underwent RC between March 1, 2017 and May 31, 2021.
Of the 304 patients, the da Vinci Xi® (Xi) was used in 159 and the da Vinci SP® (SP) was used in 145. The mean operation time was 45.7 mins in the SP group versus 49.8 mins in the Xi group. The mean docking time of the SP group was shorter than that of the Xi group (5.7 min vs 8.8 min; p = 0.024). The mean immediate postoperative numerical rating scale (NRS) score was 4.0 in the SP group and 4.3 in the Xi group, showing a significant difference (p = 0.003). A separate analysis of only patients with acute cholecystitis treated with the da Vinci SP® showed that the immediate postoperative NRS score in the acute group was higher than that in the nonacute group.
This study demonstrated acceptable results of single-site cholecystectomy using da Vinci SP®. Thus, pure single-port RC using the da Vinci SP® for various benign gallbladder diseases may be an excellent treatment option.
单孔腹腔镜胆囊切除术于 1995 年首次引入,具有可接受的美容效果和术后疼痛控制。由于外科医生和患者对微创手术的偏好,最近许多研究都检查了腹腔镜和机器人辅助单孔胆囊切除术的结果。最近推出了一个下一代达芬奇机器人平台。本研究旨在评估使用达芬奇 SP®系统进行机器人胆囊切除术(RC)的可行性和疗效。
在这项回顾性观察性单中心研究中,我们分析了 2017 年 3 月 1 日至 2021 年 5 月 31 日期间接受 RC 的 304 名患者的病历。
在 304 名患者中,达芬奇 Xi®(Xi)用于 159 例,达芬奇 SP®(SP)用于 145 例。SP 组的平均手术时间为 45.7 分钟,Xi 组为 49.8 分钟。SP 组的平均对接时间短于 Xi 组(5.7 分钟比 8.8 分钟;p=0.024)。SP 组的即时术后数字评分量表(NRS)评分为 4.0,Xi 组为 4.3,差异有统计学意义(p=0.003)。仅对接受达芬奇 SP®治疗的急性胆囊炎患者进行单独分析显示,急性组的即时术后 NRS 评分高于非急性组。
本研究表明使用达芬奇 SP®进行单部位胆囊切除术的结果可接受。因此,使用达芬奇 SP®对各种良性胆囊疾病进行纯单孔 RC 可能是一种极好的治疗选择。