Single-Port Robotic Cholecystectomy in Pediatric Patients: Single Institution Experience

J Laparoendosc Adv Surg Tech A. 2017 Apr;27(4):434-437. doi: 10.1089/lap.2016.0484. Epub 2016 Dec 19.

Abstract

Introduction: Modifications to conventional laparoscopic cholecystectomy are aimed to decrease abdominal pain and improve cosmetic results. Single-port robotic cholecystectomy is a safe and feasible approach that has been reported in adults, though reports are limited in children. This study aims to report our experience with single-port robotic cholecystectomy in children, and to evaluate the safety, feasibility, and outcomes of this approach.

Methods: After single-port robotic approach was available at our institution, we prospectively followed our patients who underwent a single-port robotic cholecystectomy from March 2013 to May 2015 in our children's hospital.

Results: There were 14 patients [female 11 (79%) versus male 3 (21%)], the average age was 12.20 ± 4.97 years, with a mean body mass index of 28.01 ± 8.57 m/kg2. Of the 14 patients, 4 (29%) had cholelithiasis with choledocolithiasis and had undergone an endoscopic retrograde cholangiopancreatography before the operation, 6 (43%) had symptomatic cholelithiasis, and 4 (28%) had acute cholecystitis. The median operative room time was 125 minutes (range 60-202), the median time of operation was 77.5 minutes (range 64-169), the median estimated blood loss was 2 mL (range 2-25), and a median length of stay was 1 day (range 0-2). There were no conversions to another approach. The median follow-up was 7 months (range 3-22). One patient (7%) developed an umbilical port site seroma, which was managed conservatively, no other complications occurred.

Conclusions: Single-port robotic cholecystectomy is a feasible and safe approach for cholecystectomy in the pediatric population. More studies are required to compare it to different approaches.

Keywords: cholecystectomy; pediatric; robotic; single-port.

MeSH terms

  • Adolescent
  • Child
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholecystectomy, Laparoscopic / methods
  • Cholecystitis, Acute / surgery*
  • Choledocholithiasis / surgery*
  • Cholelithiasis / surgery*
  • Female
  • Humans
  • Male
  • Operative Time
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Robotic Surgical Procedures / methods
  • Seroma / epidemiology
  • Umbilicus