Pediatric Robotic Laryngeal Cleft Repair.

Area of Science:

• Pediatric surgery
• Otolaryngology
• Minimally invasive techniques

Background:

• Laryngeal cleft (LC) repair aims to improve swallowing and reduce aspiration.
• Traditional surgical methods for LC repair include open and endoscopic approaches.
• Robotic surgery offers potential advantages in precision and visualization for complex procedures.

Purpose of the Study:

• To compare surgical and swallowing outcomes between robotic and traditional laryngeal cleft (LC) repairs in pediatric patients.
• To evaluate the efficacy of robotic-assisted LC repair for different cleft types and recurrent cases.

Main Methods:

• Retrospective cohort study conducted at a tertiary care pediatric hospital.
• Included pediatric patients who underwent robotic or traditional LC repair between 2010 and 2021.
• Compared patient characteristics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow study (MBSS) results.

Main Results:

• Robotic Type I LC repairs had longer surgical and OR times but improved 12-month MBSS outcomes compared to traditional repairs.
• Robotic Type II and III LC repairs showed decreased hospital LOS and trending improvements in MBSS.
• Robotic surgery successfully revised all recurrent LC cases that failed traditional repairs.

Conclusions:

• Robotic LC repair, particularly for Type I, offers improved postoperative swallowing outcomes despite increased operative time and LOS.
• The robotic approach may be especially beneficial for managing recurrent laryngeal clefts.
• Further research with larger cohorts is needed to confirm benefits for Type II and III LC repairs.