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Robotic-assisted colectomy in children: a comparative study with laparoscopic surgery.

Garance Martin1,2, Louise Montalva3,4, Stéphane Paré2,5

  • 1Department of Pediatric Surgery, Robert-Debré Children University Hospital, 48 Boulevard Sérurier, 75019, Paris, France.

Journal of Robotic Surgery
|June 19, 2023
PubMed
Summary

Robotic-assisted colectomy in children is as safe and feasible as laparoscopic colectomy, showing similar complication rates. However, robotic surgery involves longer operative times and higher costs compared to the laparoscopic approach.

Keywords:
Crohn’s diseaseDa VinciLaparoscopic colectomyMinimally invasive surgeryRobot-assisted colectomy

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Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Laparoscopic colectomy (LapC) and robotic-assisted colectomy (RobC) are minimally invasive surgical options for children.
  • Comparative outcome data between these approaches in pediatric colectomy are essential for clinical decision-making.

Purpose of the Study:

  • To compare the outcomes and costs of laparoscopic versus robotic-assisted colectomy in a pediatric population.
  • To evaluate the safety and feasibility of both surgical techniques in children undergoing colectomy.

Main Methods:

  • A retrospective review of pediatric patients who underwent LapC or RobC between January 2010 and March 2023.
  • Data collected included demographics, surgical details, and 30-day post-operative outcomes.
  • Statistical analysis used Fisher tests for categorical and Mann-Whitney tests for continuous variables.

Main Results:

  • Fifty-five colectomies were performed (31 LapC, 24 RobC), with inflammatory bowel disease being the primary indication.
  • RobC was associated with significantly longer operative times (3h vs 2.5h, p=0.02) and an additional median cost of 2156€.
  • Post-operative complication rates were similar between LapC (35%) and RobC (38%, p=0.99), with no conversions in either group.

Conclusions:

  • Robotic-assisted colectomy is a safe and feasible alternative to laparoscopic colectomy in children.
  • While complication rates are comparable, the robotic approach incurs increased operative times and costs.
  • Further research may explore cost-effectiveness and long-term outcomes for pediatric robotic colectomy.