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Related Experiment Video

Updated: Jun 21, 2025

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Robotic-assisted pull-through procedures for anorectal malformation: a systematic review.

Shilpa Sharma1,2, Viji Geetha3

  • 1Professor, Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India. drshilpas@gmail.com.

Pediatric Surgery International
|July 16, 2024
PubMed
Summary

Robotic-assisted pull-through procedures for anorectal malformation (ARM) are feasible and safe in infants, offering enhanced dexterity and visualization. Addressing prolonged operative times and costs through surgeon training and high-volume centers is key for wider adoption.

Keywords:
Anorectal malformationRobotic-assisted anorectoplastyRobotics

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Area of Science:

  • Minimally Invasive Surgery
  • Pediatric Surgery
  • Surgical Robotics

Background:

  • Anorectal malformation (ARM) requires complex surgical correction.
  • Robotic-assisted surgery offers potential advantages in complex pediatric procedures.

Purpose of the Study:

  • To review the literature on robotic-assisted pull-through procedures for anorectal malformation (ARM).
  • To evaluate the safety, feasibility, and technical aspects of robotic surgery in pediatric ARM cases.

Main Methods:

  • A systematic PubMed search was conducted using keywords 'robotic AND Anorectal malformation'.
  • Ten relevant publications describing 33 pediatric cases were analyzed for safety, feasibility, technical details, and limitations.

Main Results:

  • Robotic-assisted anorectoplasty (RAARP) was performed in infants as young as 3 months, predominantly in males.
  • Complications included pelvic abscess, epididymo-orchitis, and stricture; however, robotic advantages like 3D magnification and dexterity were noted.
  • Mean operative time was 228.7 minutes, with a mean hospital stay of 7 days; prolonged operating time and cost were identified as limitations.

Conclusions:

  • Robotic surgery is a feasible and safe option for infants with ARM when performed by experienced surgeons.
  • Robotics offers superior ergonomics, tremor filtration, 3D visualization, and dexterity, enhancing surgical precision.
  • Increased awareness, referral to high-volume centers, and surgeon training can mitigate cost and operative time concerns.