title: Single-Site Robotic Cholecystectomy at an Inner-City Academic Center.
abstract: BACKGROUND
  We investigate the safety and efficacy of single-site robotic cholecystectomy compared to laparoscopic cholecystectomy at an inner-city academic medical center.
  
  
  METHODS
  Retrospective analysis comparing single-site robotic to laparoscopic cholecystectomies from August 1, 2013, to January 31, 2015, was conducted. Age, gender, race, body mass index (BMI), total operative time (docking and console time for robotic cases), length of stay, comorbidities, and conversion to open procedures were examined. The χ(2) and Student's t test were used for categorical and continuous data, respectively. A P ≤ 0.05 was considered statistically significant.
  
  
  RESULTS
  From August 2013 to January 2015, 70 single-site robotic cholecystectomies and 70 laparoscopic cholecystectomies were performed. Patients were older (mean age, 40.3 years vs 47.6 years; P = .0084), had a higher mean BMI (29.5 vs 32.4 kg/m(2); P = .011), and had a higher assigned ASA (American Society of Anesthesiologists) classification (P = .024) in the laparoscopic than in the single-site group. Hypertension was more common in the laparoscopic group (P = .0078). Average docking time was 11.5 (SD 5.7) minutes, and the average console time was 52.8 (SD 22.5) minutes in the single-site group. Total operating time for the laparoscopic and single-site groups was not significantly different (111.5 minutes vs 106.0 minutes; P = .38). There were more conversions to open procedures in the laparoscopic compared to the single-site group (11 vs 1; P = .007). There were no biliary tree injuries and no deaths in either group.
  
  
  CONCLUSIONS
  Single-site robotic cholecystectomy is safe to perform in an inner-city academic hospital setting. Surgical resident involvement does not adversely affect outcomes.
authors.affiliation: Department of Surgery.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Chung
authors.affiliation: College of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York.
authors.forename: Raymond
authors.initials: R
authors.lastname: Huang
authors.affiliation: College of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York.
authors.forename: Lucas
authors.initials: L
authors.lastname: Policastro
authors.affiliation: Department of Surgery.
authors.forename: Roseanna
authors.initials: R
authors.lastname: Lee
authors.affiliation: Department of Surgery.
authors.forename: Alexander
authors.initials: A
authors.lastname: Schwartzman
authors.affiliation: Department of Surgery.
authors.forename: Antonio
authors.initials: A
authors.lastname: Alfonso
authors.affiliation: Department of Surgery.
authors.forename: Gainosuke
authors.initials: G
authors.lastname: Sugiyama
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome
keywords: Education; Minimally invasive surgery; Outcomes; Robotic surgery