title: Robot-assisted laparoscopic cholecystectomy: initial Mayo Clinic Scottsdale experience.
abstract: OBJECTIVE
  To review a single institution's experience with robot-assisted laparoscopic cholecystectomy.
  
  
  METHODS
  We reviewed retrospectively all cholecystectomies performed with the assistance of a surgical robot at the Mayo Clinic in Scottsdale, Ariz, from October 2002 to July 2003. Cholanglograms were obtained intraoperatively for patients with elevated results on liver function tests. The gallbladder was removed by the surgeon with the use of the robot. A surgical assistant at the operating table exchanged instruments in the robot arms and applied clips when needed. Total operating time, assembly time of the robot, complications, and postoperative course were evaluated.
  
  
  RESULTS
  Nineteen patients underwent robot-assisted laparoscopic cholecystectomy; 16 had symptomatic cholelithiasis, 2 had gallbladder polyps, and 1 had acute cholecystitis. Of the 19 surgeries, 16 were completed successfully with robotic assistance. In 3 consecutive patients, a mechanical problem occurred with the robot; however, all procedures were completed laparoscopically. The mean set-up time, including patient positioning and preparation and robotic installation, was 28.1 minutes. The mean +/- SD operating time was 82.3+/-17.9 minutes without a cholanglogram and 102+/-20.9 minutes with a cholanglogram. There were no complications and no conversions to an open procedure.
  
  
  CONCLUSIONS
  Robotic surgery offers many potential advantages, including surgeon comfort, elimination of surgeon tremor, improved imaging, and increased degrees of freedom of the operative Instruments, compared with conventional laparoscopic surgery. However, patient outcomes and operative costs need to be evaluated further.
authors.affiliation: Division of General Surgery, Mayo Clinic College of Medicine, Scottsdale, Ariz 85259, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Miller
authors.forename: Richard T
authors.initials: RT
authors.lastname: Schlinkert
authors.forename: Denise K
authors.initials: DK
authors.lastname: Schlinkert
mesh_terms: D000328:Adult; D000368:Aged; D001130:Arizona; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012371:Robotics