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Robot-Assisted Pull-Through for Anorectal Malformations: Comparative Observational Study of Functional Outcomes with
Quentin Ballouhey1, Pierre Meignan2, Pauline Lopez1
1Service de chirurgie viscérale pédiatrique, Hôpital des Enfants, Limoges, France.
Summary
Robot-assisted anorectal pull-through (RAARP) shows promising functional results for high anorectal malformations (ARMs) compared to traditional posterior sagittal anorectoplasty (PSARP). RAARP demonstrated better constipation scores, suggesting a potential advancement in pediatric surgical care for ARMs.
Area of Science:
- Pediatric Surgery
- Surgical Robotics
- Anorectal Malformations
Background:
- Robotic surgery is increasingly used in pediatric surgery but faces challenges in confined spaces like the neonatal pelvis.
- Assessing the efficacy of robotic techniques for complex procedures is crucial.
Purpose of the Study:
- To compare the functional outcomes of robot-assisted anorectal pull-through (RAARP) versus posterior sagittal anorectoplasty (PSARP) in children with high anorectal malformations (ARMs).
Main Methods:
- A multicenter review of patients with ARMs operated using the da Vinci® system (2007-2020).
- Comparison of 10 RAARP patients with 10 PSARP patients using Kelly and Krickenbeck scores at 3 years of age.
Main Results:
- The RAARP group had significantly lower clinical Kelly scores (P = .012) and Krickenbeck constipation scores (P = .02) compared to the PSARP group.
- No significant differences were observed in soiling scores or voluntary bowel movements between the two groups.
Conclusions:
- Robot-assisted anorectal pull-through (RAARP) is a viable alternative to PSARP for high ARM surgery, offering satisfactory functional results.
- Further long-term studies are needed to confirm the potential benefits of robotic surgery in preserving perirectal nerves.
