Innovative minimally invasive gastric pull-up techniques in children: SILS and robot-assisted gastric pull-up
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Read the article on link.springer.com ↗Article · Nov 2024 · 1 min read
In brief
In brief
This study evaluates two minimally invasive approaches for gastric pull-up reconstruction in 12 pediatric patients with esophageal pathology: single-incision laparoscopic surgery (SILS) and robot-assisted techniques. Both methods demonstrated safety and effectiveness with no mortality or major intraoperative complications, offering promising alternatives to traditional open surgery in children requiring esophageal replacement.
- SILS and robot-assisted gastric pull-up are safe, feasible alternatives for esophageal replacement in pediatric patients with strictures or atresia
- Conduit route selection (posterior mediastinum, intrathoracic, or retrosternal) should be individualized based on underlying pathology and anatomy
- Zero mortality and no intraoperative complications were observed across 12 pediatric cases using these minimally invasive techniques
- Oral feeding was successfully achieved in all patients except one with Down syndrome, demonstrating good functional outcomes
- Both SILS-GPU and R-GPU show lower complication rates compared to traditional open approaches in the pediatric population
Written by the GCMD Library team from the article.
Abstract
Aim
This study aims to explore the rationality, feasibility, safety, and effectiveness of single-incision laparoscopic gastric pull-up (SILS-GPU) and robot-assisted gastric pull-up (R-GPU) methods.
Methods
Hospital records of patients who underwent gastric pull-up with either SILS-GPU or R-GPU between May2016 and January 2024 were reviewed. Demographics, diagnosis, surgical techniques, and postoperative outcomes were evaluated.
Results
Out of the total 12 patients (eight persistent corrosive esophageal stricture—PCES, four long gap esophageal atresia—LGEA), seven underwent SILS-GPU, while the remaining five underwent R-GPU. The choice of conduit route was based on the primary pathology (PCES/EA) and the presence of posterior mediastinal fibrosis and/or tracheomalacia. The posterior mediastinum was preferred in seven, intrathoracic in three, and retrosternal in two patients. Transhiatal esophagectomy was performed in seven patients, while transthoracic esophagectomy was performed in three. There were no instances of mortality or intraoperative complications related to the preferred technique. All patients except one with Down syndrome were able to feed orally.
Conclusion
SILS-GPU and R-GPU are demonstrated to be safe and effective in the pediatric population, with relatively lower complication rates in children.