Single-port laparoscopic and robotic cholecystectomy in obesity (>25 kg/m2)

Abstract

Background and Objectives: Single-port cholecystectomy has emerged as an alternative technique to reduce the number of ports and improve cosmesis. Few previous studies have assessed obesity-related surgical outcomes following single-port cholecystectomy. In this study, technical feasibility and surgical outcomes of single-port laparoscopic cholecystectomy (SPLC) and robotic single-site cholecystectomy (RSSC) in obese patients were investigated. Methods: We conducted a two-center collaborative study and retrospectively reviewed initial experiences of RSSC and SPLC in patients whose body mass index was over 25 kg/m2. Medical records of patients were reviewed. Clinical characteristics and short-term oncologic outcomes were considered and compared between SPLC and RSSC groups. Results: RSSC and SPLC were performed in 39 and 78 patients, respectively. In comparative analysis, the total operative time was longer in the RSSC group (109.92 minutes vs. 60.99 minutes; P ±.001). However, requiring additional port for completion of surgical procedure was less frequent in the RSSC group (0% vs. 12.8%; P =.029). Immediate postoperative pain score was not significantly different between the two groups (4.95 vs. 5.00; P =.882). However, pain score was significantly lower in the RSSC group at the time of discharge (1.79 vs. 2.38; P =.010). Conversion to conventional multiport cholecystectomy, intraoperative bile spillage, or complication rate was not significantly different between the two groups (P >.05). Conclusions: SPLC and RSSC could be safely performed in selected patients with high body mass index, showing no significant clinical differences.