Safety of robotic cholecystectomy as index training procedure: the UK experience.
Stefanova I., Alkhatib O., Sheel A., Alabraba E., Alibrahim M., Arshad A., Awan A., Baron R., Bhatti I., Bhogal R., Dhakshinamoorthy V., Diaz-Nieto R., Dunne D., Frampton AE., Green A., Hajibandeh S., Hamady Z., Horgan L., Kissane E., Krishnan S., Kumar R., Lahiri R., Lam S., Liau S-S., Marangoni G., Moudhgalya S., Papadopoulos G., Pencavel T., Picker S., Ramsingh J., Riga A., Silva M., Soonawalla Z., Subar D., Sud V., Upasani V., Wong V., Worthington T., Yeung KTD., Ahmad J.
AIMS: To evaluate the safety profile of robotic cholecystectomy performed within the United Kingdom (UK) Robotic Hepatopancreatobiliary (HPB) training programme. METHODS: A retrospective evaluation of prospectively collected data from eleven centres participating in the UK Robotic HPB training programme was conducted. All adult patients undergoing robotic cholecystectomy for symptomatic gallstone disease or gallbladder polyp were considered. Bile duct injury, conversion to open procedure, conversion to subtotal cholecystectomy, length of hospital stay, 30-day re-admission, and post-operative complications were the evaluated outcome parameters. RESULTS: A total of 600 patients were included. The median age was 53 (IQR 65-41) years and the majority (72.7%; 436/600) were female. The main indications for robotic cholecystectomy were biliary colic (55.5%, 333/600), cholecystitis (18.8%, 113/600), gallbladder polyps (7.7%, 46/600), and pancreatitis (6.2%, 37/600). The median length of stay was 0 (IQR 0-1) days. Of the included patients, 88.5% (531/600) were discharged on the day of procedure with 30-day re-admission rate of 5.5% (33/600). There were no bile duct injuries and the rate of conversion to open was 0.8% (5/600) with subtotal cholecystectomy rate of 0.8% (5/600). CONCLUSION: The current study confirms that robotic cholecystectomy can be safely implemented to routine practice with a low risk of bile duct injury, low bile leak rate, low conversion to open surgery, and low need for subtotal cholecystectomy.