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2015 ; 94
(42
): e1871
Nephropedia Template TP
Medicine (Baltimore)
2015[Oct]; 94
(42
): e1871
PMID26496344
show ga
This study aims to introduce an alternative technique for effective single-site
robotic cholecystectomy (SSRC) using a reverse port.Proper exposure of Calot's
triangle is critical for safe laparoscopic cholecystectomy. Current robotic
surgical systems are useful for single-site cholecystectomy. However, in exposing
Calot's triangle, the gallbladder is usually retracted in a medial and upward
direction, resulting in a narrow triangle. This intraoperative view is a major
obstacle to safe laparoscopic cholecystectomy.From October 2013 to October 2014,
55 consecutive patients underwent SSRC by a single surgeon at Yonsei University
Severance Hospital. Initially, 5 patients underwent the original robotic single
site cholecystectomy technique, and the remaining 50 patients underwent robotic
single site cholecystectomy using our reverse port technique.There were no
differences between the SSRC-O (original port) group and the SSRC-R (reverse
port) group in terms of patient age (P = 0.244), body mass index (P = 0.503), and
pathologic conditions of the gallbladder (P = 0.841). Total operation time (132.6
vs 99.12 min; P = 0.009), actual dissection time (51.6 vs 30.28 min; P = 0.001),
and console time (84.4 vs 50.46 min; P = 0.001) were all significantly shorter in
the SSRC-R group. Mean intraoperative blood loss was minimal in both groups (20
vs 12.4 mL, P = 0.467), and bile spillage occurred in 2 patients of the SSRC-R
group. There was one case of laparoscopic conversion in the SSRC-R group.The
reverse port technique described in this study successfully widened Calot's
triangle and improved the safety of the current robotic surgical system for
single-site robotic cholecystectomy.