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Pediatric Single-Incision Robotic Cholecystectomy: A 6-Year Update from a Single Institution
Matthew T Hey1, Mackenzie Mayhew1, Stephani Rico2
1Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
Insights
Robotic cholecystectomy is a safe and effective treatment for gallbladder disease in children. This study shows single-incision robotic surgery is reliable for adolescents, with low conversion rates.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Childhood obesity is increasing gallbladder disease prevalence in pediatric populations.
- Laparoscopic cholecystectomy is standard, but robotic-assisted surgery is gaining interest.
- Robotic surgery offers potential advantages in complex pediatric cases.
Purpose of the Study:
- To update the 6-year experience with robotic-assisted surgery for gallbladder disease in children.
- To evaluate the safety and efficacy of single-incision robotic cholecystectomy in adolescents.
- To analyze operative outcomes and patient demographics.
Main Methods:
- Prospective data collection of demographic and operative variables from October 2015 to May 2021.
- Descriptive analysis of continuous variables using medians and interquartile ranges (IQRs).
- Review of 103 robotic cholecystectomies (102 single-incision, 1 subtotal).
Main Results:
- 103 robotic cholecystectomies performed; 79.6% of patients were female, median age 15 years.
- Median procedure time was 84 minutes, median console time was 41 minutes.
- Symptomatic cholelithiasis was the most common diagnosis (79.6%); 0.97% conversion to open surgery.
Conclusions:
- Single-incision robotic cholecystectomy is a safe and reliable surgical option for pediatric gallbladder disease.
- Robotic surgery demonstrates feasibility and good outcomes in the adolescent population.
- This technique supports minimally invasive treatment options for pediatric surgical conditions.
Abstract:
In children, gallbladder disease has become more common due to the rise in childhood obesity and subsequent shift in etiology. While the gold standard of surgical management remains a laparoscopic technique, there has been increasing interest in robotic-assisted techniques. The aim of this study is to report a 6-year update on the experience of treating gallbladder disease with robotic-assisted surgery at a single institution. A database was created to prospectively collect patient demographic and operative variables at the time of operation from October 2015 to May 2021. Descriptive analysis of select available variables was performed using median and interquartile ranges (IQRs) for all continuous variables. In total, 102 single-incision robotic cholecystectomies and one single-port subtotal cholecystectomy were performed. From available data, 82 (79.6%) patients were female, median weight was 66.25 kg (IQR: 58.09-74.24 kg), and median age was 15 years (IQR: 15-18 years). Median procedure time was 84 minutes (IQR: 70.25-103.5 minutes) and median console time was 41 minutes (IQR: 30-59.5 minutes). The most frequent preoperative diagnosis was symptomatic cholelithiasis (79.6%). One (0.97%) operation was converted from a single-incision robotic approach to open. Single-incision robotic cholecystectomy is a safe and reliable technique for the treatment of gallbladder disease in the adolescent population.
