Robotic-assisted laparoscopic management of mesenteric cysts in children

Chen, Qingjiang; Zhang, Shuhao; Luo, Wenjuan; Cai, Duote; Zhang, Yuebin; Huang, Zongwei; Xuan, Xiao-xiao; Xiong, Qi; Gao, Zhigang

doi:10.3389/fped.2022.1089168

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…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%

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Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Duhoky,

Claxton,

Piozzi

et al. 2024

Children

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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.

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Section: Resultsmentioning

confidence: 99%

“…Five out of eight studies reported LOSs (3.5 to 7.8 days), and there were very limited data on readmissions and reinterventions. There were no IOCs reported, and only one conversion (3.0%) occurred in Meehan et al’s study [ 16 , 20 , 21 , 23 , 25 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Duhoky,

Claxton,

Piozzi

et al. 2024

Children

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“…It is di cult to distinguish their boundaries by the naked eye using ordinary laparoscopic instruments, and complete resection is di cult, especially in those patients it is located in the root of the mesentery. Therefore, it is di cult to perform traditional laparoscopic surgery under total laparoscopy in some patients, making it necessary to enlarge the umbilical incision or even to transfer to laparotomy to resect the diseased cysts and the bowels and perform intestinal anastomosis [15]. Although surgical trauma is still reduced compared with laparotomy, when cysts are removed for intestinal anastomosis, some bowel loops still need to be exposed outside the body, thus increasing the risk of postoperative intestinal adhesions and intestinal stula.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Resection of Mesenteric Cysts in Pediatric Patients: a single-centered Retrospective study

Chen,

Cai

et al. 2024

Preprint

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Background Mesenteric cysts (MCs) are rare intra-abdominal masses in childhood. Laparoscopic-assisted surgery has become the main procedure for their resection, but robot-assisted surgery has rarely been reported. The purpose of this study was to retrospectively analyze and present our experience with robot-assisted resection of MCs using the da Vinci Xi surgical system and to discuss the technical points. Methods Children diagnosed with abdominal MCs who underwent surgical treatment at the Children's Hospital of Zhejiang University School of Medicine between January 2020 and November 2023 were retrospectively analyzed, and clinical data, surgical details, and prognosis of the patients were systematically collected. Results Among 40 patients, a total of 18 underwent robot-assisted surgery and 22 underwent laparoscopic-assisted surgery. In the robot-assisted surgery group, the entire procedure was performed endoscopically, whereas in the laparoscopic surgery group, eight procedures were converted to laparotomy. The operation time of 134.5 minutes for the robot-assisted group was not significantly longer than the 104 minutes for the laparoscopic-assisted surgery group (P > 0.05), but the average length of postoperative hospital stay was significantly shorter (P < 0.05). Conclusions Robotic-assisted resection of MCs is safe and feasible and the refinement of the Da Vinci Xi surgical system was much better than that of the conventional laparoscopic equipment, resulting in significantly improved intraoperative and postoperative outcomes.

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“…Previously reported laparoscopic surgeries for abdominal lymphatic malformations include two surgical approaches. One is complete laparoscopic surgery, which is widely used in adult patients with a large abdominal cavity, and the other is laparoscopic-assisted exploration to first locate and decompress the cyst of lymphatic malformations, followed by cyst excision through a slightly expanded umbilical incision, which is more commonly used in pediatric patients [ 16 , 30 – 32 ]. Large cysts in pediatric patients could impair surgical visualization during laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic surgery, including robotic-assisted and laparoscopic-assisted surgery, has become an option for treating ML and OL, but previous reports are sparse with small sample sizes [ 14 – 16 ]. In addition, to our knowledge, no studies have systematically compared the clinical characteristics, surgical management and prognosis of ML and OL.…”

Section: Introductionmentioning

confidence: 99%

Mesenteric and omental lymphatic malformations in children: seven-year surgical experience from two centers in China

Yan,

Fu,

Liu

et al. 2024

BMC Pediatr

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Purpose To compare the clinical characteristics, surgical management and prognosis of mesenteric lymphatic malformations (ML) and omental lymphatic malformations (OL) in children. Methods This retrospective study included 148 ML patients and 53 OL patients who underwent surgical treatment at two centers between January 2016 and December 2022. Details about the patients’ clinical characteristics, cyst characteristics, preoperative complications, surgical methods, and prognosis were retrieved and compared. Results No significant differences in sex ratio, prenatal diagnosis, or age of diagnosis were noted between ML and OL patients. Vomiting was more common in ML patients than in OL patients (46.6% vs. 22.6%, P = 0.002), but OL patients were more likely to be misdiagnosed (35.8% vs. 18.9%, P = 0.012). The size of the cysts in OL patients was significantly larger than that in ML patients (14.0 [4.0–30.0] vs. 10.0 [2.0–50.0] cm, P<0.001), and cysts with turbid fluid were more common in OL patients (38.0% vs. 20.6%, P<0.001). More OL patients than ML patients had preoperative hemorrhage or infection of cysts (41.5% vs. 31.8%, P<0.016). Cyst excision was performed in 137 (92.6%) ML patients and 51 (96.2%) OL patients, and the incidence of postoperative complications was lower (12.6% vs. 4.2%, P = 0.165) among OL patients. The main postoperative complications included adhesive ileus and recurrence of cysts. Additionally, more OL patients than ML patients were treated with laparoscopic surgery (69.8% vs. 39.2%, P<0.001). Conclusions There were differences in clinical characteristics, cyst characteristics and preoperative complications between ML and OL patients. Cyst excision was the most common surgical method that was used to treat both ML and OL patients, and laparoscopic surgery could be a feasible surgical approach for treating OL patients with a good prognosis. Trial registration Retrospectively registered.

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Robotic-assisted laparoscopic management of mesenteric cysts in children

Cited by 5 publications

References 22 publications

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Robot-Assisted Resection of Mesenteric Cysts in Pediatric Patients: a single-centered Retrospective study

Mesenteric and omental lymphatic malformations in children: seven-year surgical experience from two centers in China

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