Single-port robotic cholecystectomy using the da Vinci SP system versus single-port laparoscopic cholecystectomy:...

Single-port surgery has been emphasized, with a focus on its technical challenges, patient satisfaction, and advances in the field, especially since the advent of single-port robotic systems. Our aims in this study were to compare the clinical outcomes of single-port cholecystectomy between the laparoscopic and robotic da Vinci SP approaches.

We analyzed data from patients who underwent single-port cholecystectomy for symptomatic gallstones or gallbladder polyps. We compared 176 patients who underwent single-port laparoscopic cholecystectomy with 243 patients who underwent single-port robotic cholecystectomy.

Operation time, conversion rate, confirmation rate of a critical view of safety, complication rate, and pathologic results did not differ significantly between the two groups. The mean operative time was comparable between both groups (59.0 ± 36.1 vs 54.3 ± 22.9 min, p = 0.134). Hospital stay was shorter in the robotic group, although it was not significant after adjustment. The robotic group showed significantly lower postoperative pain scores and reduced opioid use. Although the robotic group included more cases with inflammatory or adhesive changes, the rate of achieving a critical view of safety and the overall complication rate did not differ between groups. Gallbladder perforation occurred more frequently in the laparoscopic group. Bile duct-related complications were rare and successfully managed by endoscopic retrograde cholangiopancreatography.

We conclude that single-port robotic cholecystectomy and single-port laparoscopic cholecystectomy are both feasible and safe surgical techniques. However, single-port robotic cholecystectomy has clinical advantages, primarily lower postoperative pain and a reduced analgesic requirement than the laparoscopic technique.