Innovative minimally invasive gastric pull-up techniques in children: SILS and robot-assisted gastric pull-up

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Esophageal reconstruction is complex in pediatric patients.
• Traditional open techniques carry significant morbidity.
• Advancements in minimally invasive surgery offer potential benefits.

Purpose of the Study:

• To evaluate the safety and effectiveness of single-incision laparoscopic gastric pull-up (SILS-GPU).
• To assess the feasibility and outcomes of robot-assisted gastric pull-up (R-GPU).
• To compare SILS-GPU and R-GPU in pediatric patients requiring gastric pull-up.

Main Methods:

• Retrospective review of hospital records for pediatric patients undergoing SILS-GPU or R-GPU (May 2016 - January 2024).
• Analysis of patient demographics, diagnoses, surgical techniques, and postoperative outcomes.
• Evaluation of conduit route selection based on pathology and anatomical factors.

Main Results:

• Twelve pediatric patients included: 7 SILS-GPU, 5 R-GPU.
• Common indications: persistent corrosive esophageal stricture (PCES) and long gap esophageal atresia (LGEA).
• No mortality or intraoperative complications; high rate of successful oral feeding post-surgery.

Conclusions:

• SILS-GPU and R-GPU are safe and effective for pediatric gastric pull-up.
• Minimally invasive approaches demonstrate lower complication rates in children.
• These techniques offer viable alternatives for complex esophageal reconstructions.