Is less more? A meta-analysis comparing single-port and multi-port robotic surgery in children

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Single-port (SP) robotic surgery offers reduced trauma compared to multi-port (MP) approaches.
• Its efficacy in pediatric surgery requires further definition.
• This meta-analysis evaluates SP versus MP robotic surgery in children.

Purpose of the Study:

• To assess the safety and perioperative outcomes of SP robotic surgery.
• To compare SP robotic surgery with MP robotic surgery in pediatric patients.
• To determine the feasibility of SP robotic surgery in children.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched major databases (PubMed, Scopus, Web of Science, Medline, Cochrane) up to June 2024.
• Included studies comparing SP and MP robotic surgery in pediatric patients (0-18 years), analyzing operative time, console time, blood loss, hospital stay, conversions, and complications.

Main Results:

• Analyzed 5 retrospective studies with 147 pediatric patients (87 MP, 60 SP).
• No significant differences in operative time, console time, or complication rates between SP and MP robotic surgery.
• SP robotic surgery showed significantly lower blood loss and a trend towards shorter hospital stays.

Conclusions:

• SP robotic surgery is a feasible and safe alternative to MP approaches in pediatric patients.
• Potential benefits include reduced blood loss and shorter hospital stays, particularly noted in pyeloplasty.
• Larger prospective studies are recommended due to the heterogeneity and retrospective nature of current evidence.