Multiport and Single-Site Robotic Cholecystectomy

  • Eric KubatEmail author
  • Dan Eisenberg
  • Sherry M. Wren


This chapter reviews the fundamentals and technology, robotic setup, general operative technique, and adoption considerations for robotic-assisted multiport and single-site cholecystectomy. Basic fundamental knowledge of the robotic system, the procedure setup, and instrumentation is critical prior to performing robotic-assisted cholecystectomy. A graduated training program that includes online education, simulation, direct observation, bedside assistance, and case proctoring is important for the implementation of a safe and effective robotic-assisted cholecystectomy.


Robotic cholecystectomy Multiport Single site Single incision 


  1. 1.
    Himpens J, Leman G, Cadiere GB. Telesurgical laparoscopic cholecystectomy. Surg Endosc. 1998;12:1091.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Hughes-Hallett A, Mayer EK, Marcus HJ, Cundy TP, Pratt PJ, Parston G, et al. Quantifying innovation in surgery. Ann Surg. 2014;260:205–11.CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Vidovszky TJ, Smith W, Ghosh J, Ali MR. Robotic cholecystectomy: learning curve, advantages, and limitations. J Surg Res. 2006;136:172–8.CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Miller DW, Schlinkert RT, Schlinkert DK. Robot-assisted laparoscopic cholecystectomy: initial Mayo Clinic Scottsdale experience. Mayo Clin Proc. 2004;79:1132–6.CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Wren SM, Curet MJ. Single-port robotic cholecystectomy: results from a first human use clinical study of the new da Vinci single-site surgical platform. Arch Surg. 2011;146:1122–7.CrossRefPubMedCentralGoogle Scholar
  6. 6.
    Eisenberg D, Vidovszky TJ, Lau J, Guiroy B, Rivas H. Comparison of robotic and laparoendoscopic single-site surgery systems in a suturing and knot tying task. Surg Endosc. 2013;27:3182–6.CrossRefPubMedCentralGoogle Scholar
  7. 7.
    NIH releases consensus statement on gallstones, bile duct stones and laparoscopic cholecystectomy. Am Fam Physician. 1992;46:1571–4.Google Scholar
  8. 8.
    SAGES. Guidelines for the clinical application of laparoscopic biliary tract surgery. 2010. Accessed 4 Nov 4 2015. 2013 Jun 24:1–30.
  9. 9.
    Ahmad G, O'Flynn H, Duffy JMN, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2012;2:CD006583.Google Scholar
  10. 10.
    Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg. 2010;211:132–8.CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Ishizawa T, Kaneko J, Inoue Y, Takemura N, Seyama Y, Aoki T, et al. Application of fluorescent cholangiography to single-incision laparoscopic cholecystectomy. Surg Endosc. 2011;25:2631–6.CrossRefPubMedCentralGoogle Scholar
  12. 12.
    Spinoglio G, Priora F, Bianchi PP, Lucido FS, Licciardello A, Maglione V, et al. Real-time near-infrared (NIR) fluorescent cholangiography in single-site robotic cholecystectomy (SSRC): a single-institutional prospective study. Surg Endosc. 2012;27:2156–62.CrossRefPubMedCentralGoogle Scholar
  13. 13.
    Barbash GI, Glied SA. New technology and health care costs--the case of robot-assisted surgery. N Engl J Med. 2010;363:701–4.CrossRefPubMedCentralGoogle Scholar
  14. 14.
    Rosemurgy A, Ryan C, Klein R, Sukharamwala P, Wood T, Ross S. Does the cost of robotic cholecystectomy translate to a financial burden? Surg Endosc. 2015;29:2115–20.CrossRefPubMedCentralGoogle Scholar
  15. 15.
    Bedeir K, Mann A, Youssef Y. Robotic single-site versus laparoscopic cholecystectomy: which is cheaper? A cost report and analysis. Surg Endosc. 2016;30(1):267–72.CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Pryor AD, Tushar JR, DiBernardo LR. Single-port cholecystectomy with the TransEnterix SPIDER: simple and safe. Surg Endosc. 2010;24:917–23.CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Wiyandini JR. A framework to determine the potential for success of new medical robotic products: assessment by Cooper Scoring Model and TOPSIS analysis. 2014. Accessed 4 Nov 2015.
  18. 18.
    Nelson EC, Gottlieb AH, Müller H-G, Smith W, Ali MR, Vidovszky TJ. Robotic cholecystectomy and resident education: the UC Davis experience. Int J Med Robotics Comput Assist Surg. 2013;10:218–22.CrossRefGoogle Scholar
  19. 19.
    Spinoglio G, Lenti LM, Maglione V, Lucido FS, Priora F, Bianchi PP, et al. Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience. Surg Endosc. 2011;26:1648–55.CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Ayloo S, Choudhury N. Single-site robotic cholecystectomy. JSLS. 2014;18:e2014.00266. Scholar
  21. 21.
    Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M. Cholecystectomy using a novel single-site(®) robotic platform: early experience from 45 consecutive cases. Surg Endosc. 2012;26:2687–94.CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgeryStanford University School of Medicine, VA Palo Alto Health Care SystemPalo AltoUSA

Personalised recommendations