Comparation of robotic-assisted surgery and laparoscopic‑assisted surgery in children with Hirschsprung’s disease

Abstract

Purpose There are few studies comparing robotic-assisted surgery (RAS) and laparoscopic-assisted surgery (LAS) in Hirschsprung’s disease (HSCR). This study aimed to compare intraoperative and postoperative outcomes between RAS and LAS performed during the same period. Methods All consecutive 75 patients with pathologically diagnosed as HSCR who underwent RAS or LAS Swenson pull-through from April 2020 to Nov 2022, were included. Patients were assigned to either RAS or LAS groups and a retrospective study was performed. Results A total of 75 patients were included, among which, 23 patients received RAS and 44 received LAS. The RAS and LAS groups had similar ages, sex, weight, postoperative hospital stays, and fasting times. Compared with LAS, blood loss (p = 0.002) and the incidence of Hirschsprung-associated enterocolitis (p = 0.046) were significantly lower in the RAS group. The first onset of Hirschsprung-associated enterocolitis in patients younger than 3 months occurred significantly earlier (p = 0.043). Two patients experienced anastomotic leakage in the LAS group. The cost of RAS was significantly higher than that of LAS (p < 0.0001). Conclusion RAS is a safe and effective treatment for HSCR, and can be considered as ideal alternative for the treatment in selected HSCR children (> 6 months or > 7.5 kg), without considering its cost.