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Could ICG-aided robotic cholecystectomy reduce the rate of open conversion reported with laparoscopic approach? A head to head comparison of the largest single institution studies

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Abstract

Comparative studies between robotic and laparoscopic cholecystectomy (LC) focus heavily on economic considerations under the assumption of comparable clinical outcomes. Advancement of the robotic technique and the further widespread use of this approach suggest a need for newer comparison studies. 676 ICG-aided robotic cholecystectomies (ICG-aided RC) performed at the University of Illinois at Chicago (UIC) Division of General, Minimally Invasive and Robotic Surgery were compiled retrospectively. Additionally, 289 LC were similarly obtained. Data were compared to the largest single institution LC data sets from within the US and abroad. Statistically significant variations were found between UIC-RC and UIC-LC in minor biliary injuries (p = 0.049), overall open conversion (p ≤ 0.001), open conversion in the acute setting (p = 0.002), and mean blood loss (p < 0.001). UIC-RC open conversions were also significantly lower than Greenville Health System LC (p ≤ 0.001). Additionally, UIC ICG-RC resulted in the lowest percentages of major biliary injuries (0 %) and highest percentage of biliary anomalies identified (2.07 %). ICG-aided cholangiography and the technical advantages associated with the robotic platform may significantly decrease the rate of open conversion in both the acute and non-acute setting. The sample size discrepancy and the non-randomized nature of our study do not allow for drawing definitive conclusions.

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Authors and Affiliations

  1. Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E, Chicago, IL, 60612, USA

    A. Gangemi, R. Danilkowicz, F. E. Elli, F. Bianco, M. Masrur & P. C. Giulianotti

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  1. A. Gangemi
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  2. R. Danilkowicz
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  3. F. E. Elli
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  4. F. Bianco
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  6. P. C. Giulianotti
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Correspondence to A. Gangemi.

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Conflict of interest

Author Antonio Gangemi, Author Rick Danilkowicz, Author Fernando Enrique Elli, Author Francesco Maria Bianco, Author Mario Masrur and Author Pier Cristoforo Giulianotti declare that they have no conflict of interest pertinent to this study.

Research involving human participants and/or animals

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Informed consent was obtained from all individual participants included in the study.

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Gangemi, A., Danilkowicz, R., Elli, F.E. et al. Could ICG-aided robotic cholecystectomy reduce the rate of open conversion reported with laparoscopic approach? A head to head comparison of the largest single institution studies. J Robotic Surg 11, 77–82 (2017). https://doi.org/10.1007/s11701-016-0624-6

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  • DOI: https://doi.org/10.1007/s11701-016-0624-6

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