Robot-assisted thoracoscopic plication for diaphragmatic eventration.

Area of Science:

• Minimally Invasive Surgery
• Pediatric Thoracic Surgery
• Robotic Surgery

Background:

• Conventional thoracoscopic plication for diaphragmatic eventration (DE) presents challenges due to rib limitations affecting trocar movement, suturing, and knot-tying.
• These limitations can lead to prolonged operative times and technical difficulties in managing DE.

Purpose of the Study:

• To evaluate the efficacy and surgical maneuvers of robot-assisted thoracoscopic plication (RATP) for diaphragmatic eventration (DE).
• To compare suturing time and complication rates between RATP and conventional thoracoscopic plication (CTP).

Main Methods:

• A retrospective review of 20 pediatric patients with DE who underwent diaphragmatic plication between January 2015 and November 2019.
• Patients were divided into two groups: RATP (9 patients) and CTP (11 patients).
• Demographics, operative details including suturing time, and complications were analyzed.

Main Results:

• No significant differences in gender, age, or weight were observed between the RATP and CTP groups.
• The suturing time was significantly shorter in the RATP group (27.7 ± 3.4 min) compared to the CTP group (48.1 ± 4.2 min) (p < 0.001).
• Recurrence occurred in one patient (9.09%) in the CTP group, with no recurrences noted in the RATP group.

Conclusions:

• Diaphragmatic plication using either RATP or CTP is a minimally invasive and effective treatment for DE in children.
• RATP overcomes intercostal limitations, facilitating delicate suturing and knot-tying with improved ergonomics.
• RATP demonstrates a reduced suturing time and a potential benefit in preventing recurrence compared to CTP.