A prospective, single-center investigation of the single-port robotic platform for cholecystectomy, gastrectomy and anti-reflux operations.

INTRODUCTION

Single-port (SP) robotic operations are the next frontier of minimally invasive surgery (MIS), promising to build upon multi-port robotic and laparoscopic techniques. This study aimed to assess the safety and feasibility of SP robotic cholecystectomy, hiatal hernia repair with fundoplication, and gastrectomy.

METHODS

With IDE and IRB approval, 12 patients underwent cholecystectomy, hiatal hernia repair with fundoplication and gastrectomy using the single-port surgical platform. All operations were undertaken through a 1.2 cm incision at the umbilicus and the patients who underwent a gastrectomy had an additional 1.2 cm incision for the stapler. Patient perioperative data were collected prospectively. Data is reported as mean ± SD.

RESULTS

Five patients underwent SP cholecystectomy for cholelithiasis or biliary dyskinesia. Console time was 172 ± 116.7 min, EBL was minimal. There were no conversions or intraoperative complications. There were no postoperative complications or mortalities. All patients were discharged the same day. Patient #5 was readmitted within 30 days for an aberrant side branch bile duct leak, treated with a percutaneous drain and a stent. Five patients underwent SP hiatal hernia repair with Nissen or Toupet fundoplication for GERD. Console time was 246 ± 16.0 min, EBL was minimal, there were no conversions or intraoperative complications. There were no postoperative complications, mortalities, or readmissions. All patients were discharged the following day. In the second phase, two patients underwent SP gastrectomy, one partial gastrectomy for GIST and one near total gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma, without conversion or perioperative complications. Both had negative margins with adequate lymph node harvest and were discharged on postoperative days 2 and 4 respectively without readmissions.

CONCLUSION

SP cholecystectomy, gastrectomy and hiatal hernia repair with fundoplication are safe and efficacious. Implementation of SP robotic surgery using the da Vinci SP platform lays the groundwork for expanding single-port robotic techniques into advanced foregut and hepatopancreatobiliary (HPB) operations.