Universität zu Köln

Datta, Rabi R., Dieplinger, Georg, Wahba, Roger, Kleinert, Robert, Thomas, Michael, Gebauer, Florian, Schiffmann, Lars, Stippel, Dirk L., Bruns, Christiane J. and Fuchs, Hans F. (2020). True single-port cholecystectomy with ICG cholangiography through a single 15-mm trocar using the new surgical platform symphonX: first human case study with a commercially available device. Surg. Endosc., 34 (6). S. 2722 - 2730. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

Background Minimally invasive single-port surgery is often associated with large incisions up to 2-3 cm, complicated handling due to the lack of triangulation, and instrument crossing. Aim of this prospective study was to perform true single-port surgery (cholecystectomy) without the use of assisting trocars using a new surgical platform that allows for triangulation incorporating robotic features, and to measure the perioperative outcome and cosmetic results. Methods As the first European site after FDA and CE-mark approval, the new device has been introduced to our academic center. In patients with cholecystitis and cholecystolithiasis, the operation was performed through only one 15-mm trocar. For patients safety, intraoperative cholangiography using intravenous ICG and a standard Stryker 1588 system was routinely performed. Results Symphonx was used in n = 12 patients for abdominal surgery (6 females, mean age 42.5 [30-77], mean BMI 26.2 [19.3-38.9]. A total of 8 patients underwent surgery using no additional ports besides the 15-mm trocar; in the remaining patients, one assisting instrument (3-5 mm) was used. Mean OR time was 107 [72-221] minutes. The postoperative course was uneventful in 11 patients; in one patient, a seroma at the surgical site required interventional drainage 1 month postoperatively. No intraoperative complications occurred. Conclusion This is the first human case series using the commercially available symphonX platform for abdominal laparoscopic surgery and the first series using the system without assisting instruments. Laparoscopic cholecystectomy in patients with cholecystitis and cholecystolithiasis using the symphonX platform through only one 15-mm trocar is feasible, safe, and more cost-efficient compared to robotic platforms.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Datta, Rabi R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dieplinger, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahba, Roger UNSPECIFIED UNSPECIFIED UNSPECIFIED Kleinert, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomas, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiffmann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Stippel, Dirk L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-130287
DOI:	10.1007/s00464-019-07229-4
Journal or Publication Title:	Surg. Endosc.
Volume:	34
Number:	6
Page Range:	S. 2722 - 2730
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY; TERM-FOLLOW-UP; INCISION CHOLECYSTECTOMY; BODY-IMAGE; SURGERY; TRIAL; EXPERIENCE; COSMESIS; METAANALYSIS; MULTICENTER Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13028