Study Of Robot-assisted Laparoscopic Cholecystectomy In Comparison With Conventional Laparoscopic Cholecystectomy.

Objective: To evaluate the feasibility , safety and superiority of robot-assisted laparoscopic cholecystectomy by comparing robot-assisted laparoscopic cholecystectomy (RLC) with conventional laparoscopic cholecystectomy(CLC).Method: 52 patients undergoing elective cholecystectomy were selected to perform robot-assisted laparoscopic cholecystectomy(RLC) and conventional laparoscopic cholecystectomy(CLC). From April 2004 to March 2005 in the hepatobiliary department of Shenzhen people's hospital. Seventeen male and 35 female patients were collected. Disease involved were gallbladder stone(48 cases) and gallbladder polyps(4 cases). Of them, 23 cases underwent RLC,the others received conventional laparoscopic cholecystectomy. The total operating time (including preparing time and operating time), action numbers of adjusting and cleaning the camera, bleeding loss, drainage volume, complications, and postoperative course were collected. All patients' blood was sampled to measurestress and immune markers(CRP, Cortisol, IL-1, IL-6, TNF, T cells, Ig-A,Ig-M, Ig-G, C3, C4 ) before operation and the first postoperative morning. Thedifference of these markers between two groups were compared. SPSS 12.0 statistical software was used to analysis these data.Results: (1) , All operations were performed successfully without conversion to open cholecystectomy and serious complications. The total operation time and setup time in RLC group were significantly more than thosein CLC group(p < 0.05 ) . The action numbers of adjusting and cleaning camera in RLC group were significantly less than those in CLC group (p < 0.05 ) . (2) , The postoperative markers of CRP, IL-1, IL-6, TNF increased significantly, while CD4/CD8, Ig-M decreased significantly after RLC. The postoperative markers ofCRP, IL-1, IL-6, TNF increased significantly, while C3, C4 decreased after CLC.(3), The stress and immune markers before and after operation were notsignificantly different betweem RLC and CLC group, neither were the diversity of the markers of two groups.Conclusion: Compared with CLC, RLC requires more operation time, but it offers greater ability of controlling operation field and reduces the actions of adjusting and cleaning camera. Robot-assisted laparoscopic cholecystectomy results in simally trauma comparing with conventional laparoscopic cholecystectomy. RLC is feasible, safe mininvasive and the patents will recover fast as well as CLC .