Robotic lobectomy in children with severe bronchiectasis: A worthwhile new technology.

Area of Science:

• Pediatric surgery
• Thoracic surgery
• Minimally invasive surgery

Background:

• Lobectomy is indicated for children with refractory, symptomatic, localized bronchiectasis.
• Inflammation associated with bronchiectasis can complicate thoracoscopic procedures.

Purpose of the Study:

• To present the initial series of robotic-assisted pulmonary lobectomy in pediatric patients with bronchiectasis.
• To compare robotic lobectomy with traditional thoracoscopic lobectomy for this condition.

Main Methods:

• Retrospective analysis of pediatric patients undergoing lobectomy for severe localized bronchiectasis (2014-2019).
• Comparison between thoracoscopic (4x 5mm ports) and robotic (4-arm Da Vinci Xi) approaches.
• Analysis of operative time, complications, and length of stay.

Main Results:

• Eighteen children underwent lobectomy (7 robotic, 11 thoracoscopic).
• Robotic surgery had no conversions to open procedures, unlike thoracoscopy (5 conversions).
• Robotic surgery had longer operative times (247 vs 152 min) but similar complication rates and length of stay.

Conclusions:

• Pediatric robotic lung lobectomy is feasible and safe, providing superior visualization and dissection capabilities.
• The technique is particularly beneficial for complex infectious lung pathologies.
• Instrumentation size may limit its application in smaller pediatric thoraxes.