Cholecystectomy, the surgical removal of the gallbladder was done with traditional open surgery until the early 1990s when laparoscopic surgery was adopted quickly because it had several advantages.
Now, some three decades later, a newer method to removal the gallbladder, robotic cholecystectomy is growing in popularity with surgeons as it too offers advantages over the older laparoscopic platform.
In the hands of an experienced robotic surgeon, the robotic instruments can manipulate tissue with much more precision then laparoscopic instruments. This allows for a potentially safer surgery with less chance of bleeding, bile spillage and inadvertent injury of nearby structures. During the laparoscopic era of cholecystectomy, there have been about 3,000 cases of common bile duct injury per year in the US alone. It is quite possible the use of robotic cholecystectomy can reduce this number.
Robotic cholecystectomy allows the use of the chemical ICG or Indocyanine Green which is a fluorescent dye that given intravenously before the surgery shows the biliary anatomy. ICG creates a road map of the important structures involved during the surgery. Preliminary studies have shown the use of ICG is associated with a reduction in the rate of common bile duct injury in robotic cholecystectomy vs laparoscopic cholecystectomy. Indocyanine Green use in robotic cholecystectomy is an advantage.
Finally, the vision with a robotic camera is superior to that of a laparoscopic camera. The view of the anatomy during robotic surgery is a high definition 3D quality image that surpasses that of laparoscopic surgery. In addition to a better quality image, the robotic camera can be manipulated to offer different angles and views not possible with laparoscopic cameras. The use of the robotic camera technology is an advantage.
Dr. David L Chengelis, MD, FACS, is an experienced robotic surgeon who has performed countless numbers of robotic cholecystectomies safely. He had performed thousands of laparoscopic cholecystectomies in the past two decades before becoming one of the leaders in robotic cholecystectomy. He is on staff at Beaumont Health, Royal Oak hospital and is available by appointment at his office in Troy, 248 291 6516.