Single Site robotic Cholecystectomy: experience after 36 cases

1. Single Site robotic Cholecystectomy:
experience after 36 cases.
San Pio X Hospital, Milan – Italy
Jacques Mégevand, MD

2. Hospitals performing Single Site procedures in Europe
12 Centers in Italy

3. May 2013  May 2015
SSRC: Single Site Robotic Cholecystectomy
36
consecutive patients were operated on with Single
Site (DaVinci Si) for gallstones.
Our Early Experience

4. First 2 cases
were tutored by an expert surgeon in Robotic Surgery
(G. Spinoglio, MD).
We performed all procedures with the same team
because of the importance of coordination between the
surgeon and the assistants.
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Our Early Experience

5. 36 pts
Women 22 pts (61%)
Men 14 pts (39%)
Mean Age 53 yy (range 21 – 77 yy)
Patients characteristics
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6. Operative Time
Mean total operative time (TOT)
77 minutes (range 55-150 minutes)
Mean robotic time (RT)
48 minutes (range 20-70 minutes)
Mean docking time: (including port placement, patients positioning, and
docking of patient cart)
15 minutes (range 10-30 minutes)
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7. Conversion rate
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Conversion to Open 1/36 (2.7%)
Severe intraoperative
complications
(Acute cystic arthery bleeding)
Conversion to Laparoscopy 2/36 (5.5%) Chronic cholecystitis

8. Clinical outcome
Hospital stay
All patients were discharged 2 days after procedure,
except the two patients who underwent laparotomic
conversion.
Morbidity
Wound infection 2.7 % (1/36)
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9. Cosmetic outcome
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10.  Restricted lateral, upper and lower movements
(close link with the camera)
 Limitations for instruments (Hook, endowrist,
absence of bipolar forceps,…...)
 Careful dissection of the hilum for Hem-o-Lock
placement
Conclusion
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11.  Feasible with an accurate patient’s selection
 Cosmetic outcome
 ICG NIR-Fluorescence imaging
Conclusion
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12. Extension of surgical indications
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Conclusion
Right colectomies
Left colectomies
Low anterior resection
Hiatal ernia repair

13. Extension of surgical indications
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Conclusion
Right colectomies
Left colectomies
Low anterior resection
Hiatal ernia repair

15. Single Site Robotic Surgery
Chief. Jacques Mégevand, MD
Andrea Rusconi, MD
Massimo Amboldi, MD
Leonardo Lenisa, MD
Ettore Lillo, MD
Roberto Grignani, MD
Jacopo Catto Ronchino, MD
Simona Borin, MD
Anna Pertusati, MD
Staff of General Surgey Dep.