Rho Seoung Yoon, Choi Munseok, Kim Sung Hyun, Hong Seung Soo, Poh Goh Brian Kim, Nagakawa Yuichi, Tanabe Minoru, Asano Daisuke, Kang Chang Moo
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yongin Severance Hospital, Yongin, Korea.
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2024 Dec;107(6):336-345. doi: 10.4174/astr.2024.107.6.336. Epub 2024 Dec 2.
Laparoscopic cholecystectomy is the gold standard procedure for benign gallbladder disease. However, reducing ports still causes frustration when using various instruments. We investigated early perioperative outcomes of laparoscopic single site + 1 cholecystectomy using ArtiSential instruments (ArtiSential laparoscopic cholecystectomy [ALC], LIVSMED).
From July 2022 to December 2022, 116 patients underwent ALC in Severance Hospital and Yongin Severance Hospital. From May 2019 to December 2022, 210 patients underwent robotic single-port cholecystectomy (RSPC). We compared clinical characteristics, perioperative outcomes, and postoperative pain scores between the ALC and RSPC groups.
Patients in the ALC group were significantly older than those in the RSPC group (51.9 years 43.9 years, P < 0.001), and the ALC group had a larger proportion of male patients (50.9% 24.8%, P < 0.001) and cases of acute cholecystitis with stones (21.6% 0.5%, P < 0.001) than the RSPC group. The groups did not differ in their estimated blood loss, postoperative complications, or hospital stays. The mean operation time of the ALC group was shorter than that of the RSPC group (56.5 minutes 94.8 minutes, P < 0.001). Although the pain scores reported on discharge day did not differ, the ALC group reported significantly lower immediate postoperative pain scores than the RSPC group (2.7 5.4, P < 0.001).
ALC is a safe and feasible procedure. ALC patients reported markedly lower immediate postoperative pain scores than RSPC patients, with comparable operative outcomes for estimated blood loss, hospital stay, and postoperative complication rates.
腹腔镜胆囊切除术是治疗良性胆囊疾病的金标准术式。然而,在使用各种器械时减少穿刺孔仍会带来困扰。我们研究了使用ArtiSential器械进行腹腔镜单孔+1胆囊切除术(ArtiSential腹腔镜胆囊切除术[ALC],LIVSMED)的早期围手术期结果。
2022年7月至2022年12月,116例患者在延世大学Severance医院和龙仁Severance医院接受了ALC手术。2019年5月至2022年12月,210例患者接受了机器人单孔胆囊切除术(RSPC)。我们比较了ALC组和RSPC组的临床特征、围手术期结果和术后疼痛评分。
ALC组患者的年龄显著大于RSPC组(51.9岁对43.9岁,P<0.001),ALC组男性患者比例(50.9%对24.8%,P<0.001)和急性结石性胆囊炎病例比例(21.6%对0.5%,P<0.001)均高于RSPC组。两组在估计失血量、术后并发症或住院时间方面无差异。ALC组的平均手术时间短于RSPC组(56.5分钟对94.8分钟,P<0.001)。虽然出院日报告的疼痛评分无差异,但ALC组术后即刻疼痛评分显著低于RSPC组(2.7对5.4,P<0.001)。
ALC是一种安全可行的手术。与RSPC患者相比,ALC患者术后即刻疼痛评分明显更低,在估计失血量、住院时间和术后并发症发生率方面的手术结果相当。