Single site cholecystectomy

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A study of 36 patients who underwent single site robotic cholecystectomy (SSRC) at a hospital in Milan, Italy was summarized. The mean total operative time was 77 minutes and mean robotic time was 48 minutes. The conversion rate to open surgery was 2.7% for one patient with acute cystic artery bleeding. All patients except the two converted to laparotomy were discharged after 2 days. Wound infection occurred in 2.7% of patients. The conclusion was that SSRC is feasible for selected patients and results in good cosmetic outcomes, but has limitations compared to conventional robotic surgery.

Single Site robotic Cholecystectomy:
experience after 36 cases.
San Pio X Hospital, Milan �C Italy
Jacques M��gevand, MD

Hospitals performing Single Site procedures in Europe
12 Centers in Italy

May 2013 ? May 2015
SSRC: Single Site Robotic Cholecystectomy
36
consecutive patients were operated on with Single
Site (DaVinci Si) for gallstones.
Our Early Experience

First 2 cases
were tutored by an expert surgeon in Robotic Surgery
(G. Spinoglio, MD).
We performed all procedures with the same team
because of the importance of coordination between the
surgeon and the assistants.
SSRC
Our Early Experience

36 pts
Women 22 pts (61%)
Men 14 pts (39%)
Mean Age 53 yy (range 21 �C 77 yy)
Patients characteristics
SSRC

Operative Time
Mean total operative time (TOT)
77 minutes (range 55-150 minutes)
Mean robotic time (RT)
48 minutes (range 20-70 minutes)
Mean docking time: (including port placement, patients positioning, and
docking of patient cart)
15 minutes (range 10-30 minutes)
SSRC

Conversion rate
SSRC
Conversion to Open 1/36 (2.7%)
Severe intraoperative
complications
(Acute cystic arthery bleeding)
Conversion to Laparoscopy 2/36 (5.5%) Chronic cholecystitis

Clinical outcome
Hospital stay
All patients were discharged 2 days after procedure,
except the two patients who underwent laparotomic
conversion.
Morbidity
Wound infection 2.7 % (1/36)
SSRC

? Restricted lateral, upper and lower movements
(close link with the camera)
? Limitations for instruments (Hook, endowrist,
absence of bipolar forceps,��...)
? Careful dissection of the hilum for Hem-o-Lock
placement
Conclusion
SSRC

? Feasible with an accurate patient��s selection
? Cosmetic outcome
? ICG NIR-Fluorescence imaging
Conclusion
SSRC

Extension of surgical indications
SSRC
Conclusion
Right colectomies
Left colectomies
Low anterior resection
Hiatal ernia repair

Single Site Robotic Surgery
Chief. Jacques M��gevand, MD
Andrea Rusconi, MD
Massimo Amboldi, MD
Leonardo Lenisa, MD
Ettore Lillo, MD
Roberto Grignani, MD
Jacopo Catto Ronchino, MD
Simona Borin, MD
Anna Pertusati, MD
Staff of General Surgey Dep.

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Single site cholecystectomy

1. Single Site robotic Cholecystectomy: experience after 36 cases. San Pio X Hospital, Milan �C Italy Jacques M��gevand, MD

2. Hospitals performing Single Site procedures in Europe 12 Centers in Italy

3. May 2013 ? May 2015 SSRC: Single Site Robotic Cholecystectomy 36 consecutive patients were operated on with Single Site (DaVinci Si) for gallstones. Our Early Experience

4. First 2 cases were tutored by an expert surgeon in Robotic Surgery (G. Spinoglio, MD). We performed all procedures with the same team because of the importance of coordination between the surgeon and the assistants. SSRC Our Early Experience

5. 36 pts Women 22 pts (61%) Men 14 pts (39%) Mean Age 53 yy (range 21 �C 77 yy) Patients characteristics SSRC

6. Operative Time Mean total operative time (TOT) 77 minutes (range 55-150 minutes) Mean robotic time (RT) 48 minutes (range 20-70 minutes) Mean docking time: (including port placement, patients positioning, and docking of patient cart) 15 minutes (range 10-30 minutes) SSRC

7. Conversion rate SSRC Conversion to Open 1/36 (2.7%) Severe intraoperative complications (Acute cystic arthery bleeding) Conversion to Laparoscopy 2/36 (5.5%) Chronic cholecystitis

8. Clinical outcome Hospital stay All patients were discharged 2 days after procedure, except the two patients who underwent laparotomic conversion. Morbidity Wound infection 2.7 % (1/36) SSRC

9. Cosmetic outcome SSRC

10. ? Restricted lateral, upper and lower movements (close link with the camera) ? Limitations for instruments (Hook, endowrist, absence of bipolar forceps,��...) ? Careful dissection of the hilum for Hem-o-Lock placement Conclusion SSRC

11. ? Feasible with an accurate patient��s selection ? Cosmetic outcome ? ICG NIR-Fluorescence imaging Conclusion SSRC

12. Extension of surgical indications SSRC Conclusion Right colectomies Left colectomies Low anterior resection Hiatal ernia repair

13. Extension of surgical indications SSRC Conclusion Right colectomies Left colectomies Low anterior resection Hiatal ernia repair

15. Single Site Robotic Surgery Chief. Jacques M��gevand, MD Andrea Rusconi, MD Massimo Amboldi, MD Leonardo Lenisa, MD Ettore Lillo, MD Roberto Grignani, MD Jacopo Catto Ronchino, MD Simona Borin, MD Anna Pertusati, MD Staff of General Surgey Dep.

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Single site cholecystectomy

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