Robotic Cholecystectomy versus Laparoscopic Cholecystectomy: Single institution experience in Korea

Abstract

To evaluate surgical benefits of robotic gallbladder surgery with new port sites using the da Vinci system by comparing the surgical outcomes of robotic and conventional laparoscopic cholecystectomy in inflammatory gallbladder disease patients. Recently, the robotic cholecystectomy has become an attempt at multiple hospitals, but controversy persisted over use of this approach in the treatment of inflammatory gallbladder disease. We undertook a comparison of the safety and outcome of robotic cholecystectomy (RC) and laparoscopic cholecystectomy (LC) in patients with inflammatory gallbladder disease. From June 2010 to March 2013 at Ajou University Medical Center in Korea, 2091 patients who underwent cholecystectomy due to the inflammation were selected. Of these patients, 583 underwent a robotic procedure using new port sites (RC group), and 1508 a conventional laparoscopic procedure (LC group). The patients were allocated into a robotic cholecystectomy (RC) group and laparoscopic cholecystectomy (LC) group, and these 2 groups were compared in terms of their clinical characteristics and surgical outcomes. There were no statistical differences between the groups in diagnosis, and laboratory findings on admission (P > 0.05). The total operation time for the RC (51.5 ± 19.6 min) was significantly longer than for the LC (42.5 ± 22.3 min; P < 0.05). Postoperative hospitalization and total hospitalization was significantly shorter after RC (1.24 ± 0.85 and 2.9 ± 1.9 days, respectively) compared with LC (1.70 ± 2.4 and 4.1 ± 5.3 days, respectively; p < 0.05). Complications occurred in 3 of the 583 patients (0.51 %) after RC and 31 of the 1508 patients (2.05 %) after LC. Conversion to open occurred in 2 patient after RC (0.34 %) and 21 patients after LC (1.39 %). These results were significant (p < 0.05 for both). This 2091 patients study confirms that RC in inflammatory gallbladder disease can be performed safely in term of complication and conversion of RC comparable to these for LC. Our findings indicated that RC could be available to all patients requiring cholecystectomy