A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases
A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases
复制标题
DOI：
10.1007/s00464-015-4583-1
复制
发表时间：
2016-07-01
影响因子：
3.1
通讯作者：
Parris, Don
中科院分区：
文献类型：
--
作者：
Gonzalez, Anthony;Murcia, Christian Hernandez;Parris, Don
最近，机器人单部位平台已被用于改善单切口腹腔镜手术(SILC)中的困难，同时保留了标准腹腔镜胆囊切除术的优点。本研究的目的是描述大系列单切口机器人胆囊切除术(SIRC)的临床结果。所有手术都是由参与这项研究的五个不同北美中心的六名外科医生进行的。研究中的所有患者都使用达芬奇(A(R))外科系统(Intuitive Surgical Inc.Sunnyvale，CA)尝试在脐部进行单一部位的胆囊切除术。共有465名患者符合研究标准。中位年龄48岁(18-89岁)；女性351人(75.5%)，超重或肥胖304人(66.4%)。除性别外，不同外科医生/地点的病例特征有显著差异。既往腹部手术226例(48.6%)。成功完成SIRC 455例(97.8%)，无中转开腹手术。中位手术时间为52min，55~85例手术时间呈减少趋势。男性、肥胖和胆道运动障碍以外的其他诊断是较长手术时间的独立预测因素。并发症发生率为2.6%。我们的大型多中心研究表明，机器人单点胆囊切除术在广泛的患者中是安全和可行的。
Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC).Medical records of consecutive patients who underwent SIRC were retrospectively reviewed. All procedures were performed by six surgeons at five different North American centers involved in the study. All patients included in the study underwent a cholecystectomy attempted through single site at the umbilicus, using the da Vinci(A (R)) Surgical System (Intuitive Surgical Inc. Sunnyvale, CA).A total of 465 patients met study criteria. Median age was 48 years (range 18-89); 351 (75.5 %) were female and 304 (66.4 %) were overweight or obese. Except for gender, case characteristics differed significantly by surgeon/site. Previous abdominal surgery was reported for 226 (48.6 %) cases. SIRC was successfully completed in 455 (97.8 %) cases, and there were no conversions to open surgery. Median surgical time was 52 min with a decreasing trend after 55-85 cases. Male gender, obesity and diagnoses other than biliary dyskinesia were independent predictors of longer surgical times. The complication rate was 2.6 %.Our large, multicenter study demonstrates that robotic single-site cholecystectomy is safe and feasible in a wide range of patients.