Safety and feasibility of robotic single-port (SP) cholecystectomy compared to conventional laparoscopic cholecystectomy: a propensity score matching analysis

초록

Background Advancements in robotic systems have expanded the scope of minimally invasive hepatobiliary surgery. Specifically, the single-port (SP) robotic system offers distinct advantages for single-incision cholecystectomy. This study aimed to evaluate perioperative outcomes between SP robotic cholecystectomy (SP RC) and conventional laparoscopic cholecystectomy (LC). Methods This retrospective, single-center study included patients who underwent LC or SP RC between November 2020 and April 2023. Propensity score matching (PSM) was performed using covariates including age, sex, body mass index, American Society of Anesthesiologists score, GB stone, GB polyp, acute cholecystitis, DM, HTN, the number of cases of preoperative ERCP, and the surgeon. Of the 1184 enrolled patients, 340 pairs were successfully analyzed after PSM. Perioperative outcomes, including operative time, pain scores, length of stay, and postoperative complications, were compared between the matched groups. Results After PSM, BMI was comparable between the LC and SP RC (24.6 vs. 25.2 kg/m2, P = 0.824). The operative time was significantly shorter in the SP RC group (45.0 vs. 40.0 min, P < 0.001). There were no significant differences in postoperative pain scores (3 vs. 3 scores, P = 0.247) or incidence of symptomatic incisional hernia (4 vs. 6 cases, P = 0.754). Conclusions SP RC demonstrated comparable safety and feasibility to conventional LC. Further prospective studies are needed to assess its broader clinical applicability.

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