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Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review

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Abstract

The role of single-incision laparoscopic cholecystectomy (SILC) and single-incision robotic cholecystectomy (SIRC) is still unclear. We update the summarization of the feasibility and safety of SILC and SIRC. A comprehensive search of SILC and SIRC of English literature published on PubMed database between January 2015 and November 2020 was performed. A total of 70 articles were included: 41 covering SILC alone, 21 showing SIRC alone, 7 reporting both, and 1 study not specified. In total, 7828 cases were recorded (SILC/SIRC/not specified, 6234/1544/50); and the gender of 7423 cases was definitively reported: the female rate was 64.0% (SILC/SIRC/not specified, 62.1%/71.5%/74.0%). The weighted mean for body mass index (BMI), operative time, blood loss and post-operative hospital stay was 25.5 kg/m2 (SILC/SIRC, 25.0/27.0 kg/m2), 73.8 min (SILC/SIRC, 68.2/88.8 min), 12.6 mL (SILC/SIRC, 12.1/14.8 mL) and 2.5 days (SILC/SIRC, 2.8/1.9 days), respectively. The pooled prevalence of an additional port, conversion to open surgery, post-operative complications, intraoperative biliary injury, and incisional hernia was 4.1% (SILC/SIRC, 4.7%/1.9%), 0.9% (SILC/SIRC, 0.7%/1.5%), 5.9% (SILC/SIRC, 6.2%/4.1%), 0.1% (SILC/SIRC, 0.2%/0.09%), and 2.1% (SILC/SIRC, 1.4%/4.8%), respectively. Compared with conventional laparoscopic cholecystectomy, SIRC has experienced more postoperative incisional hernias (risk difference = 0.05, 95% confidence interval 0.02–0.07; P < 0.0001). By far, SILC and SIRC have not been considered a standard procedure. With the innovation of medical devices and gradual accumulation of surgical experience, feasibility and safety of performing SILC and SIRC will improve.

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Acknowledgements

This study was supported by the fund of Public Welfare Technology Research Program/Social Development of Zhejiang Provincial Natural Science Foundation of China No. LGF21H030011 to Wei FQ; the fund of Zhejiang Medical and Health Science and Technology Project No. 2021KY027 to Wei FQ. The Outstanding Young Personnel Research Fund of Zhejiang Provincial People's Hospital (No. ZRY2020B012) to Wei FQ.

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  1. Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China

    Weier Wang, Xiaodong Sun & Fangqiang Wei

  2. Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China

    Weier Wang

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  1. Weier Wang
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  2. Xiaodong Sun
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Correspondence to Fangqiang Wei.

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13304_2021_1056_MOESM1_ESM.tif

Supplementary file1. Figure S1 Results of the meta-analysis on postoperative outcomes: a overall complications between SIC and CLC; b postoperative biliary injuries between SIC and CLC. SIC single-incision cholecystectomy, CLC conventional laparoscopic cholecystectomy (TIF 12992 kb)

Supplementary file2 (DOCX 251 kb)

Supplementary file3 (DOCX 242 kb)

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Wang, W., Sun, X. & Wei, F. Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review. Updates Surg 73, 2039–2046 (2021). https://doi.org/10.1007/s13304-021-01056-w

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  • DOI: https://doi.org/10.1007/s13304-021-01056-w

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