title: A comparison of robotic single-incision and traditional single-incision laparoscopic cholecystectomy.
abstract: Surgeons continually strive to improve technology and patient care. One remarkable demonstration of this is the development of laparoscopic surgery. Once this proved to be a safe and reliable surgical approach, robotics seemed a logical progression of surgical technology. The aim of this project was to evaluate the utility of robotics in the context of single-incision laparoscopic cholecystectomy (SILC).
  
  
  
  A retrospective review of a prospectively maintained database of robotic single-incision laparoscopic cholecystectomy (RSILC) and traditional SILC performed by a single surgeon at our institution from July 2010 to August 2013 was queried. All consecutive patients undergoing RSILC and SILC during this time period were included. Primary outcomes include conversion rate and operative time. Secondary outcomes include length of stay, duration of narcotic use, time to independent performance of daily activities and cost. Categorical variables were evaluated using Chi-square analysis and continuous variables using t test or Wilcoxon's rank test.
  
  
  
  Thirty-eight patients underwent RSILC and 44 underwent SILC. BMI was higher in the RSILC group, and the number of patients with prior abdominal surgeries was higher in the SILC group. Otherwise, demographics were similar between the two groups. There was no difference in conversion rate between RSILC and SILC (8 vs 11 %, p = 0.60). Mean operative time for RSILC was significantly greater compared with SILC (98 vs 68 min, p < 0.0001). RSILC was associated with a longer duration of narcotic use (2.3 vs 1.7 days, p = 0.0019) and time to independent performance of daily activities (4 vs 2.3 days, p < 0.0001). Total cost is greater in RSILC ($8961 vs $5379, p < 0.0001).
  
  
  
  While RSILC can be safely performed, it is associated with longer operative times and greater cost.
authors.affiliation: Department of Minimally Invasive Surgery, Saint Francis Hospital and Medical Center, 114 Woodland St., Hartford, CT, 06105, USA. mgustafson9@gmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Gustafson
authors.affiliation: Department of Surgery, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Lescouflair
authors.affiliation: Saratoga Center for General and Minimally Invasive Surgery, Saratoga Springs, NY, USA.
authors.forename: Randall
authors.initials: R
authors.lastname: Kimball
authors.affiliation: Department of Minimally Invasive Surgery, Saint Francis Hospital and Medical Center, 114 Woodland St., Hartford, CT, 06105, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Daoud
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000379:methods*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000191:economics / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: Cholecystectomy; Costs; Human; Robotic; Technical