Xie Zhoulonglong,Li Chenchen,Chen Sheng,et al.Comparison of single-port robotic and conventional laparoscopic surgery for choledochal cysts in children[J].Journal of Clinical Pediatric Surgery,,():1022-1026.[doi:10.3760/cma.j.cn101785-202507056-005]
Comparison of single-port robotic and conventional laparoscopic surgery for choledochal cysts in children
- Keywords:
- Laparoscopy; Robotic Surgical Procedures; Choledochal Cyst; Child
- Abstract:
- Objective To compare the characteristics and outcomes of single-port robot-assisted laparoscopic surgery and conventional multi-port laparoscopic surgery in the treatment of choledochal cysts in children. Methods This retrospective study included 20 pediatric patients with choledochal cysts treated in the Department of General Surgery at Shanghai Children’s Medical Center between January 2022 and December 2023.According to the surgical approach,patients were divided into the single-port robot-assisted laparoscopic surgery group (n=10) and the conventional multi-port laparoscopic group (n=10).The two groups were compared regarding operative time,intraoperative blood loss,postoperative fasting time,duration of drain placement,length of hospital stay,hospitalization cost,and postoperative complications. Results Compared with the conventional laparoscopic group,the single-port robotic group showed a shorter time to postoperative oral intake[3.00(2.00,4.00) days vs.4.00(3.75,5.00) days],older patient age[(8.12±3.50) years vs.(4.37±3.37) years],and higher hospitalization cost[(69,655.54±10,193.48) yuan vs.(54,102.10±5,406.47) yuan],with statistically significant differences (P<0.05).There was no significant differences between the two groups in operative time,intraoperative blood loss,postoperative hospital stay,or duration of drain placement (P>0.05). Conclusions Single-port robot-assisted laparoscopic choledochal cyst excision is safe and effective.Compared with conventional laparoscopic surgery,it offers faster postoperative recovery,more precise manipulation,fewer incisions,smaller trauma,and better cosmetic outcomes.However,it is associated with higher costs and certain limitations in younger pediatric patients.
References:
[1] Freeman NV.Choledochal cysts:N.A.Oldbourne.Ann.R.Coll.Surg.Engl.56:26, 1975[J]. J Pediatr Surg, 1975, 10(4): 563-564. DOI: 10.1016/0022-3468(75)90232-8.
[2] Wen Z, Liang HY, Liang JK, et al.Evaluation of the learning curve of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children:CUSUM analysis of a single surgeon’s experience[J]. Surg Endosc, 2017, 31(2): 778-787. DOI: 10.1007/s00464-016-5032-5.
[3] Woo R, Le D, Albanese CT, et al.Robot-assisted laparoscopic resection of a type I choledochal cyst in a child[J]. J Laparoendosc Adv Surg Tech A, 2006, 16(2): 179-183. DOI: 10.1089/lap.2006.16.179.
[4] 谢小龙, 李可为, 王川, 等.达芬奇机器人手术系统辅助儿童胆总管囊肿切除术的临床疗效分析[J]. 中华小儿外科杂志, 2021, 42(7): 610-616. DOI: 10.3760/cma.j.cn421158-20200227-00122. Xie XL, Li KW, Wang C, et al.Clinical efficacy of Da Vinci (SI) robot-assisted choledochal cyst excision in pediatrics[J]. Chin J Pediatr Surg, 2021, 42(7): 610-616. DOI: 10.3760/cma.j.cn421158-20200227-00122.
[5] 池水清, 徐银慧, 汤绍涛, 等.机器人与传统腹腔镜在小儿胆总管囊肿手术中应用的对比研究[J]. 机器人外科学杂志(中英文), 2021, 2(4): 248-254. DOI: 10.12180/j.issn.2096-7721.2021.04.002. Chi SQ, Xu YH, Tang ST, et al.Comparison between robot-assisted and traditional laparoscopic surgery on choledochal cyst excision and hepaticojejunostomy in children[J]. Chin J Robot Surg, 2021, 2(4): 248-254. DOI: 10.12180/j.issn.2096-7721.2021.04.002.
[6] 谢周龙龙, 谢晨捷, 姜大朋, 等.国产单孔机器人手术系统在儿童胆总管囊肿切除术中的初步应用[J]. 中华小儿外科杂志, 2025, 46(6): 536-540. DOI: 10.3760/cma.j.cn421158-20230721-00030. Xie ZLL, Xie CJ, Jiang DP, et al.Preliminary application of domestic single-port robotic surgical system in pediatric choledochal cyst excision[J]. Chin J Pediatr Surg, 2025, 46(6): 536-540. DOI: 10.3760/cma.j.cn421158-20230721-00030.
[7] 谢晨捷, 谢周龙龙, 严志龙, 等.国产单孔机器人手术系统在儿童卵巢肿瘤切除术中的初步应用[J]. 温州医科大学学报, 2024, 54(11): 875-879. DOI: 10.3969/j.issn.2095-9400.2024.11.003. Xie CJ, Xie ZLL, Yan ZL, et al.Preliminary application of domestic single-hole robotic surgical system in ovarian tumor excision in children[J]. J Wenzhou Med Univ, 2024, 54(11): 875-879. DOI: 10.3969/j.issn.2095-9400.2024.11.003.
[8] Kearns JT, Gundeti MS.Pediatric robotic urologic surgery-2014[J]. J Indian Assoc Pediatr Surg, 2014, 19(3): 123-128. DOI: 10.4103/0971-9261.136456.
[9] Cundy TP, Marcus HJ, Clark J, et al.Robot-assisted minimally invasive surgery for pediatric solid tumors:a systematic review of feasibility and current status[J]. Eur J Pediatr Surg, 2014, 24(2): 127-135. DOI: 10.1055/s-0033-1347297.
[10] 金益, 陈青江, 章跃滨, 等.达芬奇机器人与腹腔镜在儿童肠重复畸形切除术中的应用对比研究[J]. 临床小儿外科杂志, 2022, 21(7): 632-636. DOI: 10.3760/cma.j.cn101785-202204005-007. Jin Y, Chen QJ, Zhang YB, et al.Comparative study of Da Vinci technique versus traditional laparoscopy in the treatment of intestinal duplication[J]. DOI: 10.3760/cma.j.cn101785-202204005-007.
[11] Janetschek G.Robotics:will they give a new kick to single-site surgery?[J]. Eur Urol, 2014, 66(6): 1044-1045. DOI: 10.1016/j.eururo.2014.07.029.
Memo
收稿日期:2025-8-6。
基金项目:贵州省科技成果转化及产业化计划项目(黔科合成果—LC[2024]107)
通讯作者:严志龙;Email:dryanzhilong@163.com