Ann Surg Treat Res.  2024 Dec;107(6):336-345. 10.4174/astr.2024.107.6.336.

ArtiSential laparoscopic cholecystectomy: a comparative analysis with robotic single-port cholecystectomy

Affiliations
  • 1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yongin Severance Hospital, Yongin, Korea
  • 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 3Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
  • 4Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore
  • 5Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
  • 6Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Abstract

Purpose
Laparoscopic cholecystectomy is the gold standard procedure for benign gallbladder disease. However, reducing ports still causes frustration when using various instruments. We investigated early perioperative outcomes of laparoscopic single site + 1 cholecystectomy using ArtiSential instruments (ArtiSential laparoscopic cholecystectomy [ALC], LIVSMED).
Methods
From July 2022 to December 2022, 116 patients underwent ALC in Severance Hospital and Yongin Severance Hospital. From May 2019 to December 2022, 210 patients underwent robotic single-port cholecystectomy (RSPC). We compared clinical characteristics, perioperative outcomes, and postoperative pain scores between the ALC and RSPC groups.
Results
Patients in the ALC group were significantly older than those in the RSPC group (51.9 years vs. 43.9 years, P < 0.001), and the ALC group had a larger proportion of male patients (50.9% vs. 24.8%, P < 0.001) and cases of acute cholecystitis with stones (21.6% vs. 0.5%, P < 0.001) than the RSPC group. The groups did not differ in their estimated blood loss, postoperative complications, or hospital stays. The mean operation time of the ALC group was shorter than that of the RSPC group (56.5 minutes vs. 94.8 minutes, P < 0.001). Although the pain scores reported on discharge day did not differ, the ALC group reported significantly lower immediate postoperative pain scores than the RSPC group (2.7 vs. 5.4, P < 0.001).
Conclusions
ALC is a safe and feasible procedure. ALC patients reported markedly lower immediate postoperative pain scores than RSPC patients, with comparable operative outcomes for estimated blood loss, hospital stay, and postoperative complication rates.

Keyword

Cholecystectomy; Laparoscopic; Robotic surgical procedures; Surgical instruments
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