Retrospective Assessment of the Validity of Robotic Surgery in Comparison to Open Surgery for Pediatric Choledochal Cyst

Abstract

Purpose We evaluated the validity of robotic surgery (RS) for pediatric choledochal cyst (CC) in comparison to open surgery (OS). Materials and Methods From January 2009 to April 2013, clinical data from 79 consecutive pediatric patients with CC, who underwent RS (n=36) or OS (n=43) performed by a single pediatric surgeon, were analyzed retrospectively. Results In the RS group, the age of the patients was significantly older, compared to the OS group. Operation and anesthesia times were significantly longer in the RS group than the OS group. Fluid input rates to maintain the same urine output were significantly smaller in the RS group than the OS group. The American Society of Anesthesiologists (ASA) physical status, length of postoperative hospital stay, and the incidence of surgical complications did not differ significantly between the two groups. Conclusion Although early complications could not be avoided during the development of robotic surgical techniques, RS for pediatric CC showed results comparable to those for OS. We believe that RS may be a valid and alternative surgery for pediatric CC. After further development of robotic surgical systems and advancement of surgical techniques therewith, future prospective studies may reveal more positive results.

Laparoscopic management of choledochal cysts in infants and children: A review of current practice

“…Two to three 8 mm robotic ports were then inserted. A Nathanson liver retractor or an additional laparoscopic port might be required, otherwise the principle of robotic surgery is identical to conventional laparoscopic surgery . Despite robotic surgery making suturing and knot tying easier, the Roux loop was fashioned extracorporeally, but not intracorporeally, by robotic instruments …”

“…In theory, robotic surgery for choledochal cysts should gain popularity because it facilitates complex biliary reconstruction. However, since it was first reported in 2006, there have been only limited reports in the literature . Only two centres have published case series on robotic surgery for choledochal cysts in children .…”

“…However, since it was first reported in 2006, there have been only limited reports in the literature . Only two centres have published case series on robotic surgery for choledochal cysts in children . In a study from Korea, the outcome of robotic surgery was compared with open surgery in children with choledochal cysts .…”

“…Only two centres have published case series on robotic surgery for choledochal cysts in children . In a study from Korea, the outcome of robotic surgery was compared with open surgery in children with choledochal cysts . The study was a retrospective one, and the centre intentionally only performed robotic surgery in older children ( n = 30).…”

The Surgical Robot: Applications and Advantages in General Surgery

“…A more specialized use of the robotic system in pediatric surgery has been described with excellent results comparable to the open approach for choledochal cyst excision and biliary reconstruction [68]. This is just an example of what can be achieved by members of the surgical community who continue to innovate in their fields when they remain open to progress in a responsible manner.…”