Robotic Cholecystectomy
摘要
Patients with sickle cell disease (SCD) are prone to multiple complications throughout their lives, including those related to the formation of gallstones. Indeed, these patients are particularly at risk of developing events such as hepatic colic, cholecystitis, or angiocholitis during the course of their disease. Preventing the occurrence of these complications has become a central objective in the management of these patients, and for several years now, the benefit of prophylactic cholecystectomy in case of asymptomatic gallstones has been widely demonstrated. These patients are indeed a particularly high-risk population for developing complications related to chronic hemolysis. There is limited data on robotic-assisted cholecystectomies in patients with sickle cell disease. The patient is positioned using the French position, in a supine position, with the legs spread out and toward the ground. A pad is positioned under the tips of the scapula, at the base of the chest, in order to elevate the thoracic base (Fig. 1). The ports are placed in the Pfannenstiel line under direct vision. Robotic cholecystectomy is a procedure that can be performed using a robotic approach with a suprapubic placement of the trocars. This approach offers a precise dissection of the pedicle, good ergonomic conditions, and a postoperative course similar to the laparoscopic approach. Rules of dissection need to be respected to avoid any complications. Indocyanine green could be the standard of care using a robotic approach.