title: Robotic single-port cholecystectomy using a new platform: initial clinical experience.
abstract: BACKGROUND
  The technique of single-port laparoscopy was developed over the past years in an attempt to reduce the invasiveness of surgery. A reduction of incisions and their overall size might result in enhanced postoperative cosmesis and potentially reduce pain when compared to conventional techniques. While manual single-port laparoscopy is technically challenging, a newly approved robotic platform used with the da Vinci Si System (Intuitive Surgical, Sunnyvale, CA, USA) might overcome some of the difficulties of this technique.
  
  
  METHODS
  Patients with cholelithiasis were scheduled for robotic single-port cholecystectomy in an initial clinical trial. Demographic data, intra- and short-term postoperative results were assessed prospectively.
  
  
  RESULTS
  Twenty-eight patients (22 females/6 males; median age, 48 years) underwent robotic single-port cholecystectomy in our first week of clinical cases. Median OR time was 80 min with a median docking time of 8 min and median robotic console time of 53 min. Two patients underwent intraoperative cholangiography. Eight cases presented with adhesions, tissue alterations, or anatomical abnormalities. No conversions, intra- or postoperative complications occurred.
  
  
  CONCLUSIONS
  Robotic single-port cholecystectomy appears feasible and safe in our early experience. The robotic approach to single-port surgery seems to overcome some of the technical difficulties of manual single-port surgery. This robotic platform may facilitate completion of more complex cases.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, University Hospital Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Monika E
authors.initials: ME
authors.lastname: Hagen
authors.forename: Pascal
authors.initials: P
authors.lastname: Bucher
authors.forename: Nicolas C
authors.initials: NC
authors.lastname: Buchs
authors.forename: Francois
authors.initials: F
authors.lastname: Pugin
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005705:Gallbladder Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D011446:Prospective Studies; D012371:Robotics; D016896:Treatment Outcome; D055815:Young Adult