Abstract
BackgroundThe aim of this study was to analyze the experience of two surgeons who have different laparoscopic skills and case volume, with single-site robotic cholecystectomy (SSRC) and evaluate their learning curves.MethodsAll SSRCs performed between March 2013 and April 2015 were retrospectively reviewed. The patients were divided among two surgeons based on the surgeon’s level of laparoscopic skills and case volume. Surgeon 1 had experience in advanced laparoscopy while surgeon 2 had basic laparoscopic skills. Patients’ demographic data, intraoperative and short-term postoperative results were assessed.ResultsThe analysis included 102 patients for surgeon 1 and 15 patients for surgeon 2. There were no major or minor complications in either cohort. Operative time was significantly longer for surgeon 2, conversion to laparoscopy rate was 4% for surgeon 1 compared to 20% for surgeon 2, P = 0.044, which is statistically significant.ConclusionsSSRC is an easy and safe procedure that can be quickly learned and performed in a reproducible manner by surgeons with experienced laparoscopic skills and greater case volume.
Highlights
The aim of this study was to analyze the experience of two surgeons who have different laparoscopic skills and case volume, with single-site robotic cholecystectomy (SSRC) and evaluate their learning curves
Single-incision laparoscopic cholecystectomies aimed to reduce the number of incisions, and reduce the risk of surgical site infection, scarring and postoperative pain while allowing earlier return to the patient’s activities of daily living
Robotic surgery has become an established alternative to conventional laparoscopy by solving the problems of angulation, improving the ergonomics of single-incision technologies [7], and overcoming the intrinsic limitations of single-incision laparoscopy, as reported by Kroh et al [8]
Summary
The aim of this study was to analyze the experience of two surgeons who have different laparoscopic skills and case volume, with single-site robotic cholecystectomy (SSRC) and evaluate their learning curves. Single-incision laparoscopic cholecystectomies aimed to reduce the number of incisions, and reduce the risk of surgical site infection, scarring and postoperative pain while allowing earlier return to the patient’s activities of daily living. Navarra et al in 1997 [1] performed the first single-incision laparoscopic cholecystectomy via the trans-umbilical approach. The single-incision port approach had significant limitations, mainly associated with instrumentation and proper triangulation [6], image instability, instrument collision, limited range of motion and decrease in the amount of force available at the tips of flexible instruments. Robotic surgery has become an established alternative to conventional laparoscopy by solving the problems of angulation, improving the ergonomics of single-incision technologies [7], and overcoming the intrinsic limitations of single-incision laparoscopy, as reported by Kroh et al [8]
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