A Comparative Analysis of Hypertrophic Scars in Pediatric Patients after Robotic-Assisted Versus Conventional...

Robot-assisted laparoscopic surgery has emerged as a significant element of minimally invasive surgical techniques. Nevertheless, the impacts of port placement and the forces exerted by surgical instruments on tissue integrity, wound healing, and scar development remain inadequately understood. This study retrospectively assesses postoperative incisional scars from robot-assisted laparoscopic procedures performed at our institution between 2017 and 2023, comparing them with those observed in traditional laparoscopic procedures.

A review of 402 patients from July 1, 2017, to September 1, 2023, focused on 56 undergoing robot-assisted laparoscopic surgery. Three were excluded for follow-up issues, leaving 53 in the study group. A matched control group of 53 patients with conventional laparoscopic procedures was also included. Demographic variables such as age, gender, body mass index, and operation duration were compared. At 1 year postop, three independent surgeons assessed incision scars using the Manchester Scar Scale (MSS) and Modified Manchester Scar Scale (MMSS).

An analysis of scar tissue from 53 pediatric patients who had robot-assisted laparoscopic surgery was compared with 53 who underwent conventional laparoscopy. Parameters included vascularization, pigmentation, thickness, elevation, and elasticity. Early postoperative assessments in the robot-assisted group revealed scars with poor cosmetic outcomes-such as hyperpigmentation and elevation-necessitating a thorough review.

This study presents the first clinical report of hypertrophic scar formation at incision sites after robot-assisted laparoscopic surgery. To generalize these results and elucidate possible pathophysiological mechanisms, further studies involving larger patient groups and supported by immunohistochemical analyses are required.