title: A Comparative Study of Outcomes Between Single-Site Robotic and Multi-port Laparoscopic Cholecystectomy: An Experience from a Tertiary Care Center.
abstract: BACKGROUND
  The aim of this study was to compare the outcomes of single-site robotic cholecystectomy with multi-port laparoscopic cholecystectomy within a high-volume tertiary health care center.
  
  
  METHODS
  A retrospective analysis of prospectively maintained data was conducted on patients undergoing single-site robotic cholecystectomy or multi-port laparoscopic cholecystectomy between October 2011 and July 2014. A single surgeon performed all the surgeries included in the study.
  
  
  RESULTS
  A total of 678 cholecystectomies were performed. Of these, 415 (61%) were single-site robotic cholecystectomies and 263 (39%) were multi-port laparoscopic cholecystectomies. Laparoscopic patients had a greater mean BMI (30.5 vs. 29.0 kg/m2; p = 0.008), were more likely to have undergone prior abdominal surgery (83.3 vs. 41.4%; p < 0.001) and had a higher incidence of preexisting comorbidities (76.1 vs. 67.2%; p = 0.014) as compared to the robotic group. There was no statistical difference in the total operative time, rate of conversion to open procedure and mean length of follow-up between the two groups. The mean length of hospital stay was shorter for patients within the robotic group (1.9 vs. 2.4 days; p = 0.012). Single-site robotic cholecystectomy was associated with a higher rate of wound infection (3.9 vs. 1.1%; p = 0.037) and incisional hernia (6.5 vs. 1.9%; p = 0.006).
  
  
  CONCLUSIONS
  Multi-port laparoscopic cholecystectomy should remain the gold standard therapy for gallbladder disease. Single-site robotic cholecystectomy is an effective alternative procedure for uncomplicated benign gallbladder disease in properly selected patients. This must be carefully balanced against a high rate of surgical site infection and incisional hernia, and patients should be informed of these risks.
authors.affiliation: Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
authors.forename: Banujan
authors.initials: B
authors.lastname: Balachandran
authors.affiliation: University of Illinois Metropolitan Group General Surgery Residency, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
authors.forename: Theadore A
authors.initials: TA
authors.lastname: Hufford
authors.affiliation: Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
authors.forename: Taha
authors.initials: T
authors.lastname: Mustafa
authors.affiliation: Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
authors.forename: Kunal
authors.initials: K
authors.lastname: Kochar
authors.affiliation: Russell Institute for Research and Innovation, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
authors.forename: Suela
authors.initials: S
authors.lastname: Sulo
authors.affiliation: Division of General Surgery, Advocate Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL, USA. sentinelnode1@yahoo.com.
authors.forename: Joubin
authors.initials: J
authors.lastname: Khorsand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D013530:Surgical Wound Infection / Q000209:etiology; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult