title: A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases.
abstract: Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC).
  
  
  
  Medical records of consecutive patients who underwent SIRC were retrospectively reviewed. All procedures were performed by six surgeons at five different North American centers involved in the study. All patients included in the study underwent a cholecystectomy attempted through single site at the umbilicus, using the da Vinci(®) Surgical System (Intuitive Surgical Inc. Sunnyvale, CA).
  
  
  
  A total of 465 patients met study criteria. Median age was 48 years (range 18-89); 351 (75.5 %) were female and 304 (66.4 %) were overweight or obese. Except for gender, case characteristics differed significantly by surgeon/site. Previous abdominal surgery was reported for 226 (48.6 %) cases. SIRC was successfully completed in 455 (97.8 %) cases, and there were no conversions to open surgery. Median surgical time was 52 min with a decreasing trend after 55-85 cases. Male gender, obesity and diagnoses other than biliary dyskinesia were independent predictors of longer surgical times. The complication rate was 2.6 %.
  
  
  
  Our large, multicenter study demonstrates that robotic single-site cholecystectomy is safe and feasible in a wide range of patients.
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA. anthonyg@baptisthealth.net.
authors.forename: Anthony
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA.
authors.forename: Christian Hernandez
authors.initials: CH
authors.lastname: Murcia
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA.
authors.forename: Rey
authors.initials: R
authors.lastname: Romero
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Escobar
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Garcia
authors.affiliation: Population Health and Outcomes Research, Center for Research & Grants, Baptist Health South Florida, Miami, FL, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Walker
authors.affiliation: Population Health and Outcomes Research, Center for Research & Grants, Baptist Health South Florida, Miami, FL, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Gallas
authors.affiliation: Utica Park Clinic, Tulsa, OK, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Dickens
authors.affiliation: Premier Surgical Specialists and William Beaumont Hospital, Troy, MI, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: McIntosh
authors.affiliation: Norwood Surgical Specialists, Shreveport, LA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Norwood
authors.affiliation: Florida Hospitals, Celebration Health, Celebration, FL, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Av., Suite B210, Miami, FL, 33173, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rabaza
authors.affiliation: Population Health and Outcomes Research, Center for Research & Grants, Baptist Health South Florida, Miami, FL, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Parris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: Laparoscopic cholecystectomy; Robotic platform; Single incision