Cholecystectomy

Since the first robotic-assisted cholecystectomy was performed in 1997 by Himpens et al. in Belgium [1], several case series were reported in the literature [2, 3]. The authors of these studies did not find any significant advantages over conventional laparoscopic surgery when using the robotic system to perform the operation. They stated that the need for a specially trained operating room staff was an unnecessary hindrance for a low-complexity procedure. They also stated that the operating room costs were higher with the robotic system, due to more expensive instrumentation, robot time, and longer case time. In addition, they indicated that it was extremely difficult to perform a cholangio-gram with the system in place due to the large footprint and bulk of the robotic arms. At this time, there are no case studies or randomized controlled trials large enough to suggest the expected decrease in complications of cholecystectomy, such as common bile duct (CBD) injury. In conclusion, we postulate that the advantages of robotic technology may have potential use in advanced procedures such as repair of the common bile duct after injury, but that current evidence does not support the routine application of this technology in laparoscopic cholecystectomy.

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