title: Single-site robotic cholecystectomy in a broadly inclusive patient population: a prospective study.
abstract: OBJECTIVE
  To describe our initial experience with single-site robotic cholecystectomy (SSRC) and its applicability to a broad segment of patients.
  
  
  BACKGROUND
  At the initiation of our study, there were only 3 published reports on SSRC. These initial studies had limited inclusion criteria. We present our experience with the technical aspects and patient outcomes of SSRC in a broadly inclusive patient population.
  
  
  METHODS
  Prospective cohort study from January 2012 to January 2013, in which 95 patients underwent SSRC. Procedural times, postoperative complications, delayed hospital discharges, and re-admissions were evaluated.
  
  
  RESULTS
  Patients were predominantly female (71.6%) had mean age of 45.2 ± 6.1 years and mean body mass index (BMI) of 30.1 ± 7.1 kg/m. Overall, mean total operative time (TOT) for all patients (n = 95) was 88.63 ± 32.0 (range: 49-220) minutes. SSRC was not completed in 8 (8.42%) patients: 6 conversions to laparoscopy, 1 conversion to open, and 1 aborted case. The group of patients who were able to complete SSRC (n = 87) had a mean TOT of 83.5 ± 24.5 minutes and mean operative robotic time (RT) of 39.6 ± 15.2 minutes. RT was longer in patients with intra-abdominal adhesions (P = 0.0139) and higher BMI (P = 0.03). A minority of patients required hospital admission (11.6%), readmission (6.3%), or reoperation (1.1%). No bile duct injury or death occurred.
  
  
  CONCLUSIONS
  SSRC is safe and has a manageable learning curve. Patient factors, such as obesity, did not significantly affect conversion rates or TOTs. SSRC is a promising new technique, which can be offered to a wide array of patients.
authors.affiliation: From the Innovative Surgery of the Alimentary Tract (iSAT) Institute, Department of Surgery, University of California, Davis in Sacramento.
authors.forename: Tamas J
authors.initials: TJ
authors.lastname: Vidovszky
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Carr
authors.forename: Gina N
authors.initials: GN
authors.lastname: Farinholt
authors.forename: Hung S
authors.initials: HS
authors.lastname: Ho
authors.forename: William H
authors.initials: WH
authors.lastname: Smith
authors.forename: Mohamed R
authors.initials: MR
authors.lastname: Ali
mesh_terms: D002763:Cholecystectomy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012371:Robotics / Q000295:instrumentation*; D016896:Treatment Outcome