ArtiSential<sup>®</sup> laparoscopic cholecystectomy versus single-fulcrum laparoscopic cholecystectomy: Which minimally invasive surgery is better?

Jae Hwan Jeong; Seung Soo Hong; Munseok Choi; Seoung Yoon Rho; Pejman Radkani; Brian Kim Poh Goh; Yuichi Nagakawa; Minoru Tanabe; Daisuke Asano; Chang Moo Kang

doi:10.14701/ahbps.24-137

ArtiSential^® laparoscopic cholecystectomy versus single-fulcrum laparoscopic cholecystectomy: Which minimally invasive surgery is better?

Ann Hepatobiliary Pancreat Surg

Published online September 24, 2024; https://doi.org/10.14701/ahbps.24-137

Jae Hwan Jeong¹, Seung Soo Hong¹, Munseok Choi², Seoung Yoon Rho², Pejman Radkani³, Brian Kim Poh Goh⁴, Yuichi Nagakawa⁵, Minoru Tanabe⁶, Daisuke Asano⁶, Chang Moo Kang¹

¹Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Korea,
²Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea,
³MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, United States,
⁴Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore,
⁵Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan,
⁶Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Correspondence to: Chang Moo Kang, MD, PhD
Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-2135, Fax: +82-2-313-8289, E-mail: cmkang@yuhs.ac
ORCID: https://orcid.org/0000-0002-5382-4658

Received July 11, 2024; Revised August 24, 2024; Accepted August 29, 2024.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract: Backgrounds/Aims: In recent years, many minimally invasive techniques have been introduced to reduce the number of ports in laparoscopic cholecystectomy (LC), offering benefits such as reduced postoperative pain and improved cosmetic outcomes. ArtiSential^® is a new multi-degree-of-freedom articulating laparoscopic instrument that incorporates the ergonomic features of robotic surgery, potentially overcoming the spatial limitations of laparoscopic surgery. ArtiSential^® LC can be performed using only two ports. This study aims to compare the surgical outcomes of ArtiSential^® LC with those of single-fulcrum LC.
Methods: This retrospective study compared ArtiSential^® LC and single-fulcrum LC among LCs performed for gallbladder (GB) stones at the same center, analyzing the basic characteristics of patients; intraoperative outcomes, such as operative time, estimated blood loss, and intraoperative GB rupture; and postoperative outcomes, such as length of hospital stay, incidence of postoperative complications, and postoperative pain.
Results: A total of 88 and 63 patients underwent ArtiSential^® LC and single-fulcrum LC for GB stones, respectively. Analysis showed that ArtiSential^® LC resulted in significantly fewer cases of surgeries longer than 60 minutes (30 vs. 35 min, p = 0.009) and intraoperative GB ruptures (2 vs. 10, p = 0.007). In terms of postoperative outcomes, ArtiSential^® LC showed better results in the respective visual analog scale (VAS) scores immediately after surgery (2.59 vs. 3.73, p < 0.001), and before discharge (1.44 vs. 2.02, p = 0.01).
Conclusions: ArtiSential^® LC showed better results in terms of surgical outcomes, especially postoperative pain. Thus, ArtiSential^® LC is considered the better option for patients, compared to single-fulcrum LC.; Keywords : Laparoscopy; Cholecystectomy; Gallbladder; Minimally invasive surgical procedures