Single Site Surgery and Robotic Cholecystectomy
The concept of single port surgery appeals to the desire of Surgeons to provide their patients with procedures that will simultaneously result in equivalent surgical outcomes with the enhanced humanistic benefits of smaller incisions and enhanced postoperative cosmesis. The challenge before the surgical community now is to ensure that these results can be achieved routinely and safely.
Single port cholecystectomy is a natural choice for the application of this concept due to the frequency and often elective nature of this operation. The key to successful single port cholecystectomy will be the stringent adherence to the proper visualization and dissection techniques being utilized in standard laparoscopic cholecystectomy. In order to provide this ability multiple equipment changes have been developed and offered to surgeons. These new surgical variables include angled and flexible scopes, instruments of variable length, double curved instruments, internalized retractor devices and custom ports. The fusion of robotics and computer algorithms is the latest effort to solve these challenges.
Laparoscopic cholecystectomy continues to provide surgical challenges of its own right even when dissection and vision are optimal. The technical constraints and equipment variables associated with single port surgery and cholecystectomy should not be dismissed by early adopters of this technique. The twin goals of this procedure, technical and humanistic should always be kept in mind as achieving one at the expense of the other would suggest that the surgical community is making progress for progresses’ sake and not for the benefit of our patients.