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Robot-assisted abdominal surgery in children less than 5 months of age: retrospective cohort study
Yi Jin1, Duote Cai, Shuhao Zhang
1Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang Province, China.
Insights
Robot-assisted abdominal surgery is safe and feasible in infants under five months. This approach, using the Da Vinci robot system, can be safely extended to pediatric patients, offering potential benefits despite longer operation times for some conditions.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robot-assisted surgery (RAS) is gaining traction in pediatric care.
- While established as safe in children, its application in infants remains debated.
- This study addresses the safety and feasibility of RAS in very young children.
Purpose of the Study:
- To evaluate the safety and feasibility of robot-assisted abdominal surgery in infants under 5 months of age.
- To compare outcomes of RAS versus laparoscopic-assisted surgery in this cohort.
Main Methods:
- Retrospective analysis of 111 infants (<5 months) undergoing abdominal surgery.
- Data collected included clinical details, operative specifics, and postoperative outcomes.
- Comparison between robot-assisted surgery (67 patients) and laparoscopic-assisted surgery (44 patients).
Main Results:
- Robot-assisted surgery showed significantly less intraoperative bleeding for Hirschsprung disease but longer operation times for Hirschsprung disease and intestinal duplication.
- Operation times for choledochal cysts were comparable between robot-assisted and laparoscopic groups.
- Hospitalization expenses were higher with robot-assisted surgery, but complication rates and fasting times were similar between groups.
Conclusions:
- Robot-assisted abdominal surgery is safe and feasible in infants under 5 months.
- The findings support extending the surgical indications for the Da Vinci robot system to this young pediatric population.
Background:
Robot-assisted surgery is increasingly used in children. While robot-assisted surgery in children has been proved to be safe and feasible, use in infants is controversial. The purpose of this study was to present a study of robot-assisted abdominal surgery in children less than5 months of age.
Materials And Methods:
A retrospective analysis of 111 patients less than 5 months of age who underwent abdominal surgery from April 2020 to December 2022 in our hospital. The data included clinical information, operative details, and postoperative outcomes.
Results:
Among these 111 patients, 67 underwent robot-assisted surgery and 44 underwent laparoscopic-assisted surgery, the robot-assisted group includes 40 patients with Hirschsprung disease, 20 patients with choledochal cysts, and 7 patients with intestinal duplication, the laparoscopic-assisted group includes 26 patients with Hirschsprung disease, 9 patients with choledochal cysts, and 9 patients with intestinal duplication. For Hirschsprung disease, the operation time was significantly longer ( P =0.013) and the intraoperative bleeding was significantly less ( P =0.000) in the robot-assisted group than the laparoscopic assisted group. For choledochal cysts, the median operation time of 180 mins for the robot-assisted group was not significantly longer than the laparoscopic assisted surgery group at 160 mins ( P =0.153). For intestinal duplication, the operation time was significantly longer ( P =0.002) in the robot-assisted group than the laparoscopic assisted group. For these three diseases, the hospitalization expense was significantly higher ( P <0.05) in the robot-assisted group than the laparoscopic assisted group, there were no significant differences in complications, and postoperative fasting time between two groups ( P >0.05).
Conclusion:
Robot-assisted abdominal surgery in children less than 5 months of age is safe and feasible. This study showed that the surgical indications for the Da Vinci robot system in children can be extended to infants.
