Salim Naved, Daidone Camryn, Smith Leslie, Raza Ahsan
Research, Edward Via College of Osteopathic Medicine, Shreveport, USA.
General Surgery, Rapides Regional Medical Center, Alexandria, USA.
Cureus. 2023 Dec 10;15(12):e50271. doi: 10.7759/cureus.50271. eCollection 2023 Dec.
Objective Our goal is to describe and report the outcomes of patients undergoing robotic single-site cholecystectomy at a single institution. Background Cholecystectomy is a common procedure performed to remove the gallbladder. Robotic single-site cholecystectomy (RSSC) is rapidly emerging as a safe and feasible alternative to conventional 4-port laparoscopic techniques. Patients who undergo RSSC procedures may also have a decreased need for postoperative analgesics and a lower postoperative pain score. Methods From September 2020 to August 2023, there were 33 cases of RSSC performed by a single surgeon at a single institution. We recorded demographic data including sex, age, and BMI as well as postoperative outcome data including wound dehiscence, postoperative infection, biliary leakage, wound herniation, blood loss, and conversion to open procedure. Results The patient group included 24 females (72.7%) and nine males (27.3%) with a median age of 32 (Range: 9-70) and a median BMI of 24.2 kg/m (Range: 18.1-30.7). The majority of these patients were receiving cholecystectomies for benign conditions such as symptomatic cholelithiasis (n = 18, 54.5%), biliary dyskinesia (n = 13, 39.4%), acute cholecystitis (n = 1, 0.03%), and biliary colic (n = 1, 0.03%). The average estimated blood loss was 5.91 mL. Thirty-two patients (96.9%) were discharged home the same day of surgery. One patient was admitted overnight for observation due to severe biliary dyskinesia diagnosed preoperatively. The patient had no complications and was discharged the following day. One patient presented with acute abdominal wall cellulitis and omphalitis with no underlying abscess four weeks after the operation. They were treated with therapeutic antibiotics. No patients underwent conversion to an open procedure. There were no incidences of postoperative wound dehiscence or biliary leakages. One patient was admitted overnight for observation of biliary dyskinesia and another experienced abdominal wall cellulitis four weeks post-operation. Conclusions Although conventional multi-incision laparoscopic cholecystectomy remains the gold standard treatment for benign gallbladder disease, our study demonstrates the practicality and safety of Robotic Single-Site Cholecystectomy procedures.
目的 我们的目标是描述并报告在单一机构接受机器人单孔胆囊切除术患者的手术结果。背景 胆囊切除术是一种常见的切除胆囊的手术。机器人单孔胆囊切除术（RSSC）正迅速成为传统四孔腹腔镜技术的一种安全可行的替代方法。接受RSSC手术的患者术后对镇痛药的需求可能也会减少，术后疼痛评分更低。方法 2020年9月至2023年8月，在单一机构由一名外科医生进行了33例RSSC手术。我们记录了人口统计学数据，包括性别、年龄和体重指数（BMI），以及术后结果数据，包括伤口裂开、术后感染、胆漏、伤口疝、失血和转为开放手术。结果 患者组包括24名女性（72.7%）和9名男性（27.3%），中位年龄为32岁（范围：9 - 70岁），中位BMI为24.2 kg/m²（范围：18.1 - 30.7）。这些患者大多数因良性疾病接受胆囊切除术，如症状性胆结石（n = 18，54.5%）、胆囊运动障碍（n = 13，39.4%）、急性胆囊炎（n = 1，0.03%）和胆绞痛（n = 1，0.03%）。平均估计失血量为5.91 mL。32例患者（96.9%）在手术当天出院回家。1例患者因术前诊断为严重胆囊运动障碍而留院观察一晚。该患者无并发症，次日出院。1例患者术后四周出现急性腹壁蜂窝织炎和脐炎，无潜在脓肿。他们接受了抗生素治疗。没有患者转为开放手术。没有术后伤口裂开或胆漏的情况发生。1例患者因胆囊运动障碍留院观察一晚，另1例患者术后四周出现腹壁蜂窝织炎。结论 尽管传统的多切口腹腔镜胆囊切除术仍然是良性胆囊疾病的金标准治疗方法，但我们的研究证明了机器人单孔胆囊切除术的实用性和安全性。
