Surgical Endoscopy

, Volume 32, Issue 5, pp 2402–2408 | Cite as

Single-site robotic-assisted laparoscopic cholecystectomy in children and adolescents: a report of 20 cases

Article

Abstract

Background

Single-site laparoscopy is increasingly popular for straightforward operations like appendectomy. Due to limited triangulation and maneuverability, single-site cholecystectomy is riskier and more difficult. Robotics offer to make it easier and safer.

Methods

Twenty children and adolescents underwent robotic-assisted single-site cholecystectomy at a large academic children’s hospital. Patients were not randomized; patients were offered the option of robotic-assisted single-site (SSR) or standard four-incision laparoscopic (LAP) cholecystectomy. Demographics and perioperative details were compared with those of a comparable cohort who underwent LAP during the same period.

Results

The two groups were similar in physical characteristics and indications for operation. The robotic operations took longer but both groups received similar PRN doses of parenteral opiates. Patients in the SSR group were all discharged on the first postoperative day. There were no major complications in either group but a slightly higher incidence of minor wound complications in the SSR group.

Conclusion

Robotic-assisted single-site cholecystectomy appears to be a safe alternative to standard laparoscopy with a similar postoperative pain profile, short postoperative lengths of stay, and, for some, a superior cosmetic result. Nevertheless, it comes with longer set-up and operative times, a higher incidence of minor wound complications, an unknown but possibly higher risk of incisional hernia, and higher costs.

Keywords

Robotic surgery Single-site surgery Cholecystectomy Minimally-invasive surgery Laparoscopic cholecystectomy Biliary dyskinesia 

Notes

Compliance with ethical standards

Disclosure

Dr. Mattei has no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of SurgeryPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  2. 2.General, Thoracic and Fetal SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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