title: Robotic Single- and Multisite Cholecystectomy in Children.
abstract: BACKGROUND
  Elective cholecystectomy is a high-volume, simple procedure, well suited for the development of a pediatric robotic surgery program. Surgical robot software, by "reversing" the surgeon's hands, simplifies single-site cholecystectomy through a single incision at the umbilicus.
  
  
  METHODS
  Data were reviewed on the first nine children who had robotic cholecystectomy, with the Da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) device, at our institution. All cases were performed by a single surgeon, proctored by an experienced robotic general surgeon.
  
  
  RESULTS
  There were 9 patients: the first 4 patients had robotic multiport cholecystectomy, and the last 5 had robotic single-site cholecystectomy. Eight were girls. They were 10-18 years of age (median, 14 years). Diagnoses were biliary dyskinesia (n = 5) and symptomatic cholelithiasis (n = 4). Median body mass index was 24.9 (range, 20.2-43.8) kg/m(2). Median anesthesia time for multiport cholecystectomy was 139 (range, 120-162) minutes; median anesthesia time for single-site cholecystectomy was 169 (range 122-180) minutes. Median console time for multiport cholecystectomy was 47 (range, 44-58) minutes; median console time for single-site cholecystectomy was 69 (range, 66-86) minutes. Eight of the 9 patients went home on the day of surgery, and 1 stayed overnight. Patients were seen at 13-20 days after surgery (median, 14 days). There were no complications. There were no conversions to open surgery and none from single-site to multiport surgery.
  
  
  CONCLUSIONS
  Robotic cholecystectomy is safe and efficacious and is a suitable introductory procedure for pediatric surgeons considering a robotic surgery program. Single-site robotic cholecystectomy is a cosmetically attractive option but takes longer than multiport robotic cholecystectomy.
authors.affiliation: Department of Surgery, Albany Medical Center , Albany, New York.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Albany Medical Center , Albany, New York.
authors.forename: Gary
authors.initials: G
authors.lastname: Signor
authors.affiliation: Department of Surgery, Albany Medical Center , Albany, New York.
authors.forename: Tejinder Paul
authors.initials: TP
authors.lastname: Singh
authors.affiliation: Department of Surgery, Albany Medical Center , Albany, New York.
authors.forename: Steven
authors.initials: S
authors.lastname: Stain
authors.affiliation: Department of Surgery, Albany Medical Center , Albany, New York.
authors.forename: Christine
authors.initials: C
authors.lastname: Whyte
mesh_terms: D000293:Adolescent; D002648:Child; D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*