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01-12-2023 | Commentary

Robotic versus laparoscopic radical surgery for pediatric congenital biliary dilatation: a comparison of surgical outcomes of a single surgeon’s initial experience

Authors: Takuya Maeda, Jiahui Liu, Hiroo Uchida, Hizuru Amano, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Aitaro Takimoto, Shunya Takada, Yoichi Nakagawa, Akihiro Gouda, Yaohui Guo, Akinari Hinoki

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

This study aimed to clarify the validity of robot-assisted surgery (RAS) for pediatric patients with congenital biliary dilatation (CBD).

Methods

We retrospectively compared RAS and laparoscopic surgery (LS) for pediatric CBD performed by the same certified surgeon between 2016 and 2022.

Results

We included 6 RAS and 12 LS cases in this study. One case of RAS with laparotomy was excluded from the analysis. The patients in the two groups had comparable ages and body weights. The median surgery duration, the suture time per stitch, and the time to drain removal were 385 min, 145 s, and 5 days in the RAS group and 370 min (p = 0.28), 177 s (p = 0.03), and 6 days (p = 0.03) in the LS group, respectively. The time to create the Roux-en-Y limb was significantly longer in the RAS group. Postoperative complications occurred in one RAS case and in four LS cases.

Conclusions

Less anastomotic time per stitch and less time to drain removal suggest that RAS may contribute to accurate suturing and fine intra-pancreatic bile duct dissection. In addition, RAS requiring large movements of forceps in a large surgical field, such as Roux-en-Y creation, is inferior to LS.

Morikawa T, Ohtsuka H, Takadate T et al (2022) Laparoscopic and robot-assisted surgery for adult congenital biliary dilatation achieves favorable short-term outcomes without increasing the risk of late complications. Surg Today 52:1039–1047. https://doi.org/10.1007/s00595-021-02438-8CrossRefPubMed

Woo R, Le D, Albanese CT, Kim SS (2006) Robot-assisted laparoscopic resection of a type I choledochal cyst in a child. J Laparoendosc Adv Surg Tech A 16:179–183. https://doi.org/10.1089/lap.2006.16.179CrossRefPubMed

Guerrini GP, Esposito G, Magistri P et al (2020) Robotic versus laparoscopic gastrectomy for gastric cancer: the largest meta-analysis. Int J Surg 82:210–228. https://doi.org/10.1016/j.ijsu.2020.07.053CrossRefPubMed

Solaini L, Bocchino A, Avanzolini A et al (2022) Robotic versus laparoscopic left colectomy: a systematic review and meta-analysis. Int J Colorectal Dis 37:1497–1507. https://doi.org/10.1007/s00384-022-04194-8CrossRefPubMedPubMedCentral

Tanaka Y, Tainaka T, Sumida W et al (2018) Introduction of resection of intrahepatic bile duct stenosis-causing membrane or septum into laparoscopic choledochal cyst excision. Pediatr Surg Int 34:1087–1092. https://doi.org/10.1007/s00383-018-4320-7CrossRefPubMed

Zhang MX, Chi SQ, Cao GQ et al (2023) Comparison of efficacy and safety of robotic surgery and laparoscopic surgery for choledochal cyst in children: a systematic review and proportional meta-analysis. Surg Endosc 37:31–47. https://doi.org/10.1007/s00464-022-09442-0CrossRefPubMed

Nakagawa Y, Uchida H, Hinoki A et al (2023) Laparoscopic bile duct plasty for hilar bile duct stenosis (HBDS) in patients with congenital biliary dilatation: diagnosis of HBDS by preoperative MRCP and laparoscopic strategy to relieve HBDS. J Hepatobiliary-Pancreat Sci 30:473–481. https://doi.org/10.1002/jhbp.1235CrossRefPubMed

Tainaka T, Shirota C, Hinoki A et al (2022) Laparoscopic definitive surgery for congenital biliary dilatation with aggressive hilar bile ductoplasty and complete resection of the intrapancreatic bile duct in pediatric patients is safe and effective, comparable to open surgery. Surg Endosc 36:7352–7359. https://doi.org/10.1007/s00464-022-09132-xCrossRefPubMed

Ando H, Kaneko K, Ito F, Seo T, Ito T (1997) Operative treatment of congenital stenoses of the intrahepatic bile ducts in patients with choledochal cysts. Am J Surg 173:491–494. https://doi.org/10.1016/S0002-9610(97)00013-5CrossRefPubMed

10.

Amano H, Uchida H, Kawashima H et al (2015) The umbilical benz incision for reduced port surgery in pediatric patients. JSLS 19(e2014):00238. https://doi.org/10.4293/JSLS.2014.00238CrossRef

11.

Castillo O, Vidal-Mora I, Rodriguez-Carlin A et al (2016) Modified urethrovesical anastomosis during robot-assisted simple prostatectomy: technique and results. Prostate Int 4:61–64. https://doi.org/10.1016/j.prnil.2016.04.001CrossRefPubMedPubMedCentral

12.

Guan R, Chen Y, Yang K et al (2019) Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis. Asian J Surg 42:19–31. https://doi.org/10.1016/j.asjsur.2018.05.008CrossRefPubMed

13.

Tong G, Zhang G, Zheng Z (2021) Robotic and robot-assisted vs. Laparoscopic rectal cancer surgery a meta-analysis of short-term and long-term results. Asian J Surg 44:1549. https://doi.org/10.1016/j.asjsur.2021.08.053CrossRefPubMed

14.

Marano L, Fusario D, Savelli V et al (2021) Robotic versus laparoscopic gastrectomy for gastric cancer: an umbrella review of systematic reviews and meta-analyses. Updates Surg 73:1673–1689. https://doi.org/10.1007/s13304-021-01059-7CrossRefPubMedPubMedCentral

Title: Robotic versus laparoscopic radical surgery for pediatric congenital biliary dilatation: a comparison of surgical outcomes of a single surgeon’s initial experience
Authors: Takuya Maeda
Jiahui Liu
Hiroo Uchida
Hizuru Amano
Chiyoe Shirota
Takahisa Tainaka
Wataru Sumida
Satoshi Makita
Aitaro Takimoto
Shunya Takada
Yoichi Nakagawa
Akihiro Gouda
Yaohui Guo
Akinari Hinoki
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05548-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Robotic versus laparoscopic radical surgery for pediatric congenital biliary dilatation: a comparison of surgical outcomes of a single surgeon’s initial experience

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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