Robotic-assisted and Laparoscopic Splenectomy in Children: A Single Center Comparative Study

Abstract

Background To explore the safety, efficacy, advantages and disadvantages of robotic-assisted splenectomy (RS) in children by analyzing and comparing the clinical data of RS and traditional laparoscopic splenectomy (LS). Methods The clinical data of 35 children who underwent laparoscopic or robotic assisted splenectomy or partial splenectomy from February 2010 to October 2022 were included. A retrospective analysis based on general information, clinical data and prognosis were performed. Results Among 35 cases, 14 cases and 21 cases underwent RS and LS, respectively. The average operation time was 167 (120 to 224) minutes in the RS group and 176 (166 to 188) minutes in the LS group, the average intraoperative blood loss was 20 (8.7 to 27.5) ml in the RS group and 51 (23.5 to 75.5) mL in the LS group, the average length of hospital stay was 8 (7 to 9.25) days in the RS group and 10 (9 to 12) days in the LS group; the average hospitalization cost was 69 (67 to 71) thousand RMB in the RS group and 32 (31 to 34) thousand RMB in the LS group. There were no cases of conversion to laparotomy in the RS group, but two cases in the LS group. In terms of postoperative complications, there were one and three cases in the RS and LS group, respectively. Conclusion The Robotic Surgical System was safe and feasible in pediatric splenectomy or partial splenectomy which had the advantages of shortening the operation and hospitalization time, reducing intraoperative blood loss, the rate of conversion to laparotomy and the incidence of postoperative complications, but RS had a significantly higher hospitalization cost than LS.