Pediatric choledochal cysts on a single-incision robotic surgical platform: a non-randomized pilot study

To evaluate the feasibility and safety of single-incision robotic-assisted choledochal cyst surgery using the novel SHURUI Endoscopic Surgical Robotic System (SR-ENS-600).

Recently, the advent of single-incision (also named single-port) robotic systems has not only enhanced aesthetic results but also retained the advantages of traditional robotic surgery, making it a highly promising option for pediatric surgical procedures.

This study included 10 patients with choledochal cysts who underwent single-incision robotic assisted surgery (SIRAS) at a pediatric surgery center between November 2023 and March 2024. Clinical parameters of SIRAS were systematically evaluated, short-term postoperative outcomes and follow-up data were also analyzed. Previous data of laparoscopic surgery (LS) by the same surgeon was used as comparison data.

Nine females and 1 male were included, with a median age of 4.5 years (range 2-12 years) and a mean body mass index (BMI) of 16.28 ± 2.26 kg/m². All 10 SIRAS procedures were successfully completed without complications, and no patients required conversion to multi-port laparoscopic surgery. The median total operative time of SIRAS was 278.00 (interquartile range 241.00, 327.25) min. The median intraoperative blood loss was 12.00 (interquartile range 9.50, 15.75) ml, and no patients required blood transfusions. Only 3 patients required postoperative indwelling drainage tubes for a maximum duration of 6.5 days. Postoperative pain scores remained stable over a 24-h period. No postoperative complications were observed during the follow-up period, which ranged from 12 to 16 months (median of 14 months).

The SR-ENS-600 platform enables experienced surgical teams to perform SIRAS for pediatric choledochal cysts effectively and safely.