A retrospective multicenter study on evaluation of perioperative outcomes of single port robotic cholecystectomy comparing the xi and sp version of da vinci robotic surgical system

Introduction: Single-incision-robotic cholecystectomy (SIRC) using the da Vinci Xi system (Xi) (Intuitive, Sunnyvale, CA, USA) is a safe and effective operation. Recently, the da Vinci SP system (SP) (Intuitive) which is a new platform specialized for single-port surgery has been released. The study aimed to compare perioperative outcomes of Xi and SP in regards to SIRC. Methods: In this multicenter retrospective cohort study, patients who underwent SIRC with benign gallbladder disease between 2019 and 2020 were enrolled. In Seoul National University Hospital, Xi was used with 3 separate arms of instruments inserted through the single incision made in umbilical area. In Ewha Womans University Seoul Hospital, SP was used with single multi-channel port through the umbilical incision. Patient’s demographics, intraoperative factors, postoperative complications, and postoperative pain were investigated. Results: 258 patients underwent SIRC with Xi, and 72 patients with SP. There were significant differences between Xi and SP groups in operation time at console (23.1 vs. 20.3 min, p = 0.018), numbers of postoperative analgesic injection (4.0 vs. 3.2, p < 0.001), NRS at day of operation (5.7 vs. 4.9, p < 0.001), but no difference in total operation time (43.4 vs. 45.9, p = 0.155) and postoperative complication (0.8% vs. 0.0%, p > 0.999). SP group showed more estimated blood loss (14.3 vs. 19.2 mL, p = 0.031). Conclusions: Although operation time at console was shorter and pain was less in SP group statistically, clinical benefit appears to be minimal. Both Xi and SP can be a safe and feasible platform to perform SIRC, but further investigation is needed as prospective study.