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Single-Site Robotic Cholecystectomy: Reverse-Port Technique

 Myung Jae Jung  ;  So young Lee  ;  Sung Hwan Lee  ;  Chang Moo Kang  ;  Woo Jung Lee 
 MEDICINE, Vol.94(42) : 1871, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Cholecystectomy, Laparoscopic/instrumentation* ; Cholecystectomy, Laparoscopic/methods* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures*/instrumentation ; Young Adult
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Sung Hwan(이성환)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Jung, Myung Jae(정명재)
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