Background : Since the beginning of laparoscopic cholecystectomy, there have been many attempts to reduce the number of trocars including single-incision laparoscopic cholecystectomy (SILC). However, because of some drawbacks of SILC in difficulties and risk of bile duct injury, single-incision robotic cholecystectomy (SIRC) has come to fore as an alternative. This study aimed to compare the feasibility and safety between SIRC and SILC performed by a junior surgeon.

Methods : This is a retrospective study from March to December in 2023. We analyzed the data of SIRC and SILC performed by a junior surgeon in our facility who has experience of neither SIRC nor SILC before this period, excluding patients who performed combined abdominal operation. We compared operation time, estimated blood loss (EBL), learning curve, conversion (open or multi-trocar) rate, intra-operative conversion rate, and postoperative hospital stay.

Results : Eighty cases of SIRC without conversion, and 103 cases of SILC with 17 cases of conversion to multi-trocar were included. There were significant differences between the two groups in EBL (1.00 vs. 7.44 ml, P = 0.001), multi-trocar conversion rate (0.0 vs. 16.5 %, P < 0.001). The learning curve for the surgeon was overcame after 8 cases in SIRC and 12 cases in SILC. There was no intraoperative complications in SIRC, but one case of bile duct injury leading to Roux-en-Y hepaticojejunostomy in SILC. However, there was no open conversion case in both groups.

Conclusions : Considering operative outcomes and learning curve and safety, SIRC was superior to SILC especially for novices at single-incision minimally invasive surgery.