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Published on: November 4, 2022
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Robotic-Assisted and Laparoscopic Splenectomy in Children: A Single Center Comparative Study
Yuebin Zhang1, Shuhao Zhang1, Qingjiang Chen1
1Department of General Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Summary
Robotic-assisted splenectomy (RAS) is a safe and effective alternative to laparoscopic splenectomy (LS) in children, showing reduced blood loss and shorter hospital stays. While RAS had higher costs, it demonstrated comparable safety and efficacy for pediatric splenectomy procedures.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Splenectomy is a common surgical procedure in children.
- Laparoscopic splenectomy (LS) is widely used, but robotic-assisted splenectomy (RAS) is emerging as an alternative.
- Comparing the outcomes of RAS and LS in pediatric patients is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate the safety, efficacy, advantages, and disadvantages of robotic-assisted splenectomy (RAS) compared to laparoscopic splenectomy (LS) in pediatric patients.
- To analyze clinical data and compare outcomes between RAS and LS for splenectomy or partial splenectomy in children.
- To determine if RAS is a viable alternative to LS in pediatric surgery.
Main Methods:
- Retrospective analysis of clinical data from 35 children who underwent either RAS or LS for splenectomy or partial splenectomy between February 2010 and October 2022.
- Comparison of general information, clinical data, operative details, and patient prognosis between the RAS and LS groups.
- Statistical analysis to determine significant differences in operative time, blood loss, hospital stay, costs, and postoperative complications.
Main Results:
- The study included 14 cases of RAS and 21 cases of LS.
- Intraoperative blood loss was significantly lower in the RAS group compared to the LS group (P=.0009).
- The length of hospital stay was significantly shorter in the RAS group (P=.0015), while hospitalization costs were significantly higher (P<.0001).
- No conversions to laparotomy occurred in the RAS group, versus two in the LS group.
- Postoperative complications were comparable, with one case in the RAS group and three in the LS group.
Conclusions:
- Robotic-assisted splenectomy (RAS) is a safe and feasible option for pediatric splenectomy or partial splenectomy.
- RAS offers advantages over LS, including reduced intraoperative blood loss and shorter hospital stays.
- While RAS may incur higher initial costs, its safety and efficacy make it a valuable alternative to laparoscopic surgery in pediatric patients.
