Robotic versus laparoscopic radical surgery for pediatric congenital biliary dilatation: a comparison of surgical outcomes of a single surgeon’s initial experience
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In brief
In brief
This comparative study of 18 pediatric congenital biliary dilatation cases demonstrates that robotic-assisted surgery offers faster anastomotic suturing and earlier drain removal compared to laparoscopy, suggesting advantages for precise bile duct reconstruction. However, robotic technique showed limitations in creating the Roux-en-Y limb, indicating laparoscopy may be superior for procedures requiring large instrument movements in expansive surgical fields.
Written by the GCMD Library team from the article.
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.