Here is a paper touching on two of my favorite subjects, robotic surgery and misleading abstracts.
It is entitled “Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology” was just published ahead of print in Archives of Surgery. It is a study of 100 robotic single-incision cholecystectomies done by five Italian surgeons.
The conclusion of the abstract:
“Da Vinci single-site cholecystectomy is an easy and safe procedure for expert robotic surgeons. It allows the quick overcoming of the learning curve typical of single-incision laparoscopic surgery and may potentially increase the safety of this approach.”
From the full text of the paper, here is a summary of the results of a survey of the five surgeons who participated in the study.
Rating single port insertion technical issues using a scale of 1 to 5 with 1 being easy and 5 being difficult, one surgeon rated it a 2, two said 3 and two said 4.
Regarding the ergonomics of robotic single-site vs. standard laparoscopic 4-port cholecystectomy, two surgeons rated robotic worse and three said equal.
Comparing robotic to standard laparoscopic 4-port cholecystectomy, all five surgeons said robotic surgery was more difficult.
All five surgeons said the robotic procedure was safe based on their having performed a mean of 18 cases with a range of 12 to 42 cases.
The mean duration of the surgery was 71 minutes, which does not compare favorably to an operative time of 40 minutes from series of 238 single incision non-robotic laparoscopic cholecystectomies reported in the Journal of the American Collegeof Surgeons in 2010.
The authors state, “None of the considered [operative] times (total time and each of its main components) appeared to significantly decrease with the number of patients operated on." How is this statement reconciled with the “quick overcoming of the learning curve typical of single-incision laparoscopic surgery” mentioned in the conclusion of the abstract? No such comparison was included in the paper.
This abstract of this paper, much of which is a survey of only five surgeons with a modest experience in robotic single-incision cholecystectomy, is misleading. The paper itself suggests that compared to standard laparoscopic surgery, robotic single-incision cholecystectomy is less ergonomically comfortable, more difficult and takes longer. To say it is safe based on a series of 100 cases is premature at best.
For previous posts on robotic surgery, see the label to the right of this post.
Here is a previous post on misleading abstracts: "Reading an abstract vs. reading an entire paper."