Technical Details of Robotic Single Port (SP) Cholecystectomy in Three Progressively More Challenging Scenarios

Francesco Bianco, MD

Product Details
Product ID: ACS-6083
Year Produced: 2020
Length: 11 min.


Introduction: Robotic single site (SS) cholecystectomy has been proven to be safe and feasible. SS technique can be very challenging in the setting of acute cholecystitis and porcelain gallbladder due to some technical limitations like: non-endowristed instruments and flexible arms. The new Da Vinci Single Port platform (SP) represents the latest technical improvement over the previous robotic SS technology. The fully wristed instruments and the camera can potentially provide better visualization, effective exposure, and safer dissection while maintaining improved cosmesis. We present a video which highlights the evolution of our technique and learning curve in three progressively more challenging scenarios. Materials and Methods: Three cases are presented: symptomatic cholelithiasis, acute on chronic cholecystitis, and porcelain gallbladder. The patients past medical history is described in the video. All 3 patients were scheduled for robotic assisted cholecystectomy using the SP platform, under IRB approval. Results: The three procedures were successfully performed without conversion or intraoperative complications. There were no complications reported at follow-up in all 3 cases. The surgeon console time for symptomatic cholelithiasis, acute cholecystitis, and porcelain gallbladder are 11 min, 81 min, and 81 min respectively. Conclusion: The SP platform offers a more advanced set of instruments which allows better exposure, more sophisticated dissection and safer control of the anatomy. The new platform allowed to treat mere complex cases compared to the SS approach. More experience is needed to understand the full potential of this new technology.