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Comparative of Robotic-Assisted versus Laparoscopic-Assisted Modified Soave Pull-Through with Short Muscular Cuff
Bo Wang1, Chengyan Tang1, Xinrong Xia1
1Department of pediatric surgery, Children Hospital of Guizhou province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China.
Objective:
To compare the clinical efficacy of robotic-assisted versus laparoscopic-assisted modified Soave pull-through with short muscular cuff anastomosis in infants under 3 months of age with classical Hirschsprung's disease (HSCR).
Methods:
A retrospective analysis was conducted on 35 infants under 3 months with classical HSCR who underwent radical surgery at our hospital from January 2020 to December 2024. Among them, 19 underwent robotic-assisted surgery (robotic group), and 16 underwent laparoscopic-assisted surgery (laparoscopic group). Baseline characteristics, perioperative outcomes, postoperative complications, and defecation function were compared between the two groups.
Results:
Baseline characteristics were comparable between groups (P > 0.05). Compared with the laparoscopic group, the robotic group had significantly shorter total operative time [(142.5±16.8) min vs. (171.3±24.6) min; P < 0.05], shorter anal dissection time [(20.8±5.2) min vs. (36.7±9.8) min; P < 0.05], less intraoperative blood loss [(6.5±2.4) ml vs. (11.0±5.6) ml; P < 0.05], and shorter postoperative hospital stays [(7.2±1.6) d vs. (8.9±2.4) d; P < 0.05]. The incidence of postoperative enterocolitis was significantly lower in the robotic group [0(0%) vs. 4(25.0%); P < 0.05]. Regarding defecation function, the robotic group showed fewer daily soiling episodes [(0.8±0.6) vs. (1.6±0.9); P < 0.05] and higher Kelly scores [(2.9±0.3) points vs. (2.4±0.7) points; P < 0.05]. No significant differences were observed between the two groups in terms of anastomotic complications, need for constipation intervention, daily bowel movement frequency, or excellent rate of defecation function (P > 0.05).
Conclusion:
In this non-randomized, retrospective comparison, robotic-assisted modified Soave pull-through with short muscular cuff anastomosis was found to be safe and feasible for infants under 3 months with classical HSCR. The robotic approach was associated with shorter operative time, reduced intraoperative blood loss, shorter hospital stays, and may be associated with improved mid-term defecation function compared with laparoscopic assistance.