Laparoscopic robotic-assisted restorative proctocolectomy and ileal J-pouch-anorectal anastomosis in children

Romeo, Carmelo; Fabrizio, Donatella Di; Impellizzeri, Pietro; Arena, Salvatore; Dipasquale, Valeria; Palo, Federico; Costa, Stéfano; Pellegrino, Salvatore; Antonuccio, Pietro; Romano, Claudio; Mattioli, Girolamo

doi:10.1007/s00383-021-05017-7

Cited by 10 publications

(9 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are very few reports of robotic bowel surgery in children. Redo pull-through in Hirschsprung disease was reported to have a significantly lower complication rate after RALS (6%) compared with the open approach (21%), 45 whereas the feasibility of coloproctectomy, and ileal J-pouch in children was associated with a complication rate of 30% 46 . In surgical oncology, no robot-specific complications were noted in our study and the 3 most common complications were pleural or collection drainage and intestinal obstruction.…”

Section: Discussionmentioning

confidence: 48%

“…Redo pull-through in Hirschsprung disease was reported to have a significantly lower complication rate after RALS (6%) compared with the open approach (21%), 45 whereas the feasibility of coloproctectomy, and ileal J-pouch in children was associated with a complication rate of 30%. 46 In surgical oncology, no robot-specific complications were noted in our study and the 3 most common complications were pleural or collection drainage and intestinal obstruction. Comparison with other studies is not possible as there are very little data on robotic surgical oncology and no robust data on minimally invasive pediatric surgical oncology.…”

Section: Discussionmentioning

confidence: 55%

See 1 more Smart Citation

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Vinit

Vatta²,

Broch³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

To report one-year morbidity of robotic-assisted laparoscopic surgery (RALS) in a dedicated, multidisciplinary, pediatric robotic surgery program. Summary Background Data. RALS in pediatric surgery is expanding, but data on morbidity in children is limited. Methods: All children who underwent RALS (Da Vinci Xi, Intuitive Surgical, USA) were prospectively included (October 2016 to May 2020; follow-up ≥1 year). Analyzed data: patient characteristics, surgical indication/procedure, intraoperative adverse events (ClassIntra classification), blood transfusion, hospital stay, postoperative complications (Clavien-Dindo). Results: Three hundred consecutive surgeries were included: urology/ gynecology (n=105), digestive surgery (n=83), oncology (n=66), ENT surgery (n=28), thoracic surgery (n=18). Median age and weight at surgery were 9.5 [interquartile range (IQR)=8.8] years and 31 [IQR=29.3] kg, respectively. Over one year, 65 (22%) children presented with ≥1 complication, with Clavien-Dindo ≥III in 14/300 (5%) children at ≤30 days, 7/300 (2%) at 30-90 days, and 12/300 (4%) at >90 days. Perioperative transfusion was necessary in 15 (5%) children, mostly oncological (n=8). Eight (3%) robotic malfunctions were noted, one leading to conversion (laparotomy). Overall conversion rate was 4%. ASA ≥3, weight ≤15 kg, and surgical oncology did not significantly increase the conversion rate, complications, or intraoperative adverse events (ClassIntra ≥2). ASA score was significantly higher in children with complications (Clavien-Dindo ≥III) than without (p=0.01). Median hospital stay was 2 [IQR=3] days. Three children died after a median follow-up of 20 [IQR=16] months. Conclusions: RALS is safe, even in the most vulnerable children with a wide scope of indications, age, and weight. Robot-specific complications or malfunctions are scarce.

show abstract

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 55%

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Vinit

Vatta²,

Broch³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…After removing duplicates and title and abstract screening, 35 studies were assessed for eligibility through full-text evaluations. In the end, fifteen studies were considered eligible and included in the review ( Figure 1 ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Duhoky,

Claxton,

Piozzi

et al. 2024

Children

View full text Add to dashboard Cite

Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and recent developments in the reductions in port sizes and single-port surgery offer promising prospects. This study aimed to present a systematic overview and analysis of the existing literature around the use of robotic platforms in the treatment of paediatric gastrointestinal diseases. Materials and Methods: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale. Results: Fifteen studies were included, of which seven were on Hirschsprung’s disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, p < 0.001), but no significant differences in blood loss, length of stay, intraoperative complications, postoperative complications, or conversion. Conclusions: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery.

show abstract

“…This systematic analysis included 9 papers that evaluated ndings in 271 individuals with in ammatory bowel disease after robotic IPAA. Although all the studies were non-randomized trials, one of the studies included also evaluated the signi cance of robotic approach in the children [5].…”

Section: Discussionmentioning

confidence: 99%

Role of robotic approach in ileal pouch–anal anastomosis (IPAA): A systematic review of the literature

et al. 2022

View full text Add to dashboard Cite

Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) has become standard surgical treatment of choice in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) in which the medical management fails. Despite the wide use of laparoscopic method, the enhanced and innovative features that come with the robotic platform such as endo-wrist technology, 3D visualization, surgeon-controlled camera and motion scaling makes it an appealing choice. This study aims to investigate then feasibility and safety of robotic approach for proctectomy or proctocolectomy with IPAA as compared to conventional laparoscopic approach. A systematic review was done to for the studies done between 2010 and 2022 comparing the robotic approach with the laparoscopic approach and 9 studies were nally found to be feasible to be included in this review. In terms of the outcomes, although the mean operating time was slightly higher than the laparoscopic approach, the other outcomes such as mean blood loss, return of the bowel movement, mean hospital stay, and conversion to open were found to be signi cantly lower. Despite the overall increased rate of complications combined from all the studies, the rate of signi cant complications such as anastomotic leaks requiring readmission and return to theater was also found to be substantially less. This study concludes that although robotic approach is in its initial stages for pelvic surgeries, it can be safely employed due to improved dexterity and visibility.

show abstract

Laparoscopic robotic-assisted restorative proctocolectomy and ileal J-pouch-anorectal anastomosis in children

Cited by 10 publications

References 34 publications

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Role of robotic approach in ileal pouch–anal anastomosis (IPAA): A systematic review of the literature

Contact Info

Product

Resources

About