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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (5): 792-796    DOI: 10.31083/j.ceog.2020.05.5441
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Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy
E.D. Na1, S.H. Choi2, H. Park1, *()
1Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnamsi, Gyeonggido, Republic of Korea
2Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnamsi, Gyeonggido, Republic of Korea
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Abstract  

With the quality ergonomics and rapid learning curve of the robotic surgery system taken into consideration, robotic laparoendoscopic single-site surgery (R-LESS) appears to be the best integration for maximizing the benefits of single-site surgery. However, there are drawbacks of robot-assisted procedures which include longer operative time and higher cost, because of this, we hypothesized that the burden of robotic surgery would be reduced if two surgeries could be completed within one session in R-LESS. Three cases of R-LESS were performed for combined hysterectomy and cholecystectomy in patients with concomitant benign uterine disease and cholecystopathy. The combined surgeries were successfully conducted without additional port insertion or conversion and included the benefits of decreased hospital stay, anesthesia risk, and cost compared with the sum of two separate surgeries. Therefore, in cases in which concomitant pathologies are detected in the abdominopelvic cavity, R-LESS can be an option for selected patients with the benefit of minimally invasive surgery.

Key words:  Cholecystectomy      Hysterectomy      Robotic laparoendoscopic single site surgery     
Submitted:  07 November 2019      Accepted:  24 April 2020      Published:  15 October 2020     
*Corresponding Author(s):  H. Park     E-mail:  p06162006@cha.ac.kr

Cite this article: 

E.D. Na, S.H. Choi, H. Park. Robotic laparoendoscopic single-site surgery for concurrent hysterectomy and cholecystectomy. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(5): 792-796.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.05.5441     OR     https://ceog.imrpress.com/EN/Y2020/V47/I5/792

Figure 1.  — (A) Conventional laparoscopic port sites. (B) Robotic laparoendoscopic single-site surgery (R-LESS) central port site in the concurrent operation.

Table 1  — Characteristics and perioperative findings of patients.
Age (y) BMI (kg/m2) Clinical information Final histopathologies of specimens Operative finding Operative duration (h) Blood loss (mL) Postoperative hospital stay (d)
63 23.2 Previous conization with persistent HPV infection
Nausea and vomiting
Mild dysplasia and chronic cholecystitis Atrophic uterus with cervical os stricture 3.5 100 2
56 21.3 Acute right flank pain with hydronephrosis and chronic abdominal discomfort Uterine leiomyomas (120 g) and chronic cholecystitis with stones Leiomyoma of right uterine wall compressing the ureter 2.75 Minimal 5
49 24.1 Hypermenorrhea and postprandial discomfort Uterine leiomyomas (550 g) and chronic cholecystitis with stones Multiple leiomyomas, with the largest one having a diameter of 7 cm 3.42 250 4
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