title: Single-Port Robotic Cholecystectomy in Pediatric Patients: Single Institution Experience.
abstract: BACKGROUND
  Modifications to conventional laparoscopic cholecystectomy are aimed to decrease abdominal pain and improve cosmetic results. Single-port robotic cholecystectomy is a safe and feasible approach that has been reported in adults, though reports are limited in children. This study aims to report our experience with single-port robotic cholecystectomy in children, and to evaluate the safety, feasibility, and outcomes of this approach.
  
  
  METHODS
  After single-port robotic approach was available at our institution, we prospectively followed our patients who underwent a single-port robotic cholecystectomy from March 2013 to May 2015 in our children's hospital.
  
  
  RESULTS
  There were 14 patients [female 11 (79%) versus male 3 (21%)], the average age was 12.20 ± 4.97 years, with a mean body mass index of 28.01 ± 8.57 m/kg2. Of the 14 patients, 4 (29%) had cholelithiasis with choledocolithiasis and had undergone an endoscopic retrograde cholangiopancreatography before the operation, 6 (43%) had symptomatic cholelithiasis, and 4 (28%) had acute cholecystitis. The median operative room time was 125 minutes (range 60-202), the median time of operation was 77.5 minutes (range 64-169), the median estimated blood loss was 2 mL (range 2-25), and a median length of stay was 1 day (range 0-2). There were no conversions to another approach. The median follow-up was 7 months (range 3-22). One patient (7%) developed an umbilical port site seroma, which was managed conservatively, no other complications occurred.
  
  
  CONCLUSIONS
  Single-port robotic cholecystectomy is a feasible and safe approach for cholecystectomy in the pediatric population. More studies are required to compare it to different approaches.
authors.affiliation: 1 Department of Surgery, Cleveland Clinic Florida , Weston, Florida.
authors.forename: Armando
authors.initials: A
authors.lastname: Rosales-Velderrain
authors.affiliation: 2 Department of Pediatric Surgery, Nicklaus Children's Hospital , Miami, Florida.
authors.forename: Fuad
authors.initials: F
authors.lastname: Alkhoury
mesh_terms: D000293:Adolescent; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D041881:Cholecystitis, Acute / Q000601:surgery*; D042883:Choledocholithiasis / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods; D049291:Seroma / Q000453:epidemiology; D014472:Umbilicus
keywords: cholecystectomy; pediatric; robotic; single-port