Philip Schertz, DO, Subhasis Misra. Brandon Regional Hospital
Aim: The aim of this study is to evaluate the differences in key surgical factors for single-incision robotic cholecystectomy and multi-incision robotic cholecystectomy.
Method: A retrospective data review from August 2013 to April 2018 consisting of 104 single-incision and 105 multi-incision robotic cholecystectomies was done looking at factors including patient gender, age, operating time (skin incision to skin closure), robotic console time (docking to undocking), the preoperative diagnosis for surgery, any complications in surgery, length of stay (LOS), and estimated blood loss (EBL). Procedures with conversion away from original robotic cholecystectomy approach were excluded. Chi-square analysis using p value of 0.05 as statistical significance were run between the two data sets.
Results: A total of 209 robotic cholecystectomy cases were reviewed since 2013. We found significantly less time with single-incision compared to multi-incision (Single incision = 94.0 minutes, multi-incision = 99.9 minutes, p=0.016) and estimated blood loss (single-incision = 11.52 mL, multi-incision = 17.17 mL, p=.004). There was no significant difference in age or robotic console time. The most common indication was symptomatic cholelithiasis overall, with equal cases of dyskinesia in single-incision approach, although there was no significant difference in indication between the two approaches. Intraoperatively there was a marginally significant use of irrigation in multi-incision (multi-incision 45 (42.9%), single-incision 31 (29.8%), p=0.0499) and no difference in Firefly, perforation, or intraoperative cholangiogram use. Length of stay showed significant decreased stay in single-incision approach (single-incision 84 outpatient (80.8%), multi-incision 75 (71.4%) p=0.0379).
Conclusion: In a single center, retrospective study, single-incision and multi-incision robotic cholecystectomy showed single-incision is associated with less total operative time, blood loss, irrigation use, and shorter length of stay.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94754
Program Number: P663
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster