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Single-port Robotic Cholecystectomy (SPRC) Using the da Vinci Xi System With Straight Instruments: A Practical and
Yi-Jie Wang1, Heng-Yu Tung2, Yu-Ying Chen2
1Department of Surgery/Bariatric, Metabolic and Digestive Minimally Invasive Surgery Center, Division of General Surgery, National Defense Medical University, Tri‑Service General Hospital, Taipei, Taiwan.
Background:
Single-incision laparoscopic cholecystectomy (SILC) offers excellent cosmetic results but is technically challenging. Robotic systems can overcome these limitations, and although the da Vinci Xi is designed for multiport surgery, it can be adapted for single-port procedures. This study reports our experience performing single-port robotic cholecystectomy (SPRC) with straight instruments, emphasizing technical optimization and perioperative outcomes.
Methods:
SPRC was performed using an optimized umbilical port configuration and docking technique. Surgical steps were standardized to ensure stable traction and precise dissection, with a crossover method applied in difficult cases to improve exposure (see Supplemental Videos 1, Supplemental Digital Content 1, http://links.lww.com/SLE/A507 , and 2, Supplemental Digital Content 2, http://links.lww.com/SLE/A508 ). Eleven patients underwent SPRC, and demographic, operative, and perioperative data were analyzed.
Results:
All procedures were completed without conversion to open or multiport surgery. The mean operative time was 116.7 ± 22.2 minutes, with minimal blood loss (13.8 ± 7.5 mL). No intraoperative complications or gallbladder perforations occurred, and only one patient required temporary drainage for minor oozing. Postoperative VAS scores averaged 3.1 ± 1.0 on day 0 and 1.6 ± 0.5 on day 1, with a mean hospital stay of 2.2 ± 1.1 days. No readmissions or port-site complications were observed.
Conclusions:
SPRC with the da Vinci Xi system using straight instruments is feasible and safe. Optimized port placement and instrument coordination yield outcomes comparable to those reported for the SP system or single-site platform, providing an accessible alternative for centers without these platforms.
