Rosales-Velderrain Armando, Alkhoury Fuad
1 Department of Surgery, Cleveland Clinic Florida , Weston, Florida.
2 Department of Pediatric Surgery, Nicklaus Children's Hospital , Miami, Florida.
J Laparoendosc Adv Surg Tech A. 2017 Apr;27(4):434-437. doi: 10.1089/lap.2016.0484. Epub 2016 Dec 19.
Modifications to conventional laparoscopic cholecystectomy are aimed to decrease abdominal pain and improve cosmetic results. Single-port robotic cholecystectomy is a safe and feasible approach that has been reported in adults, though reports are limited in children. This study aims to report our experience with single-port robotic cholecystectomy in children, and to evaluate the safety, feasibility, and outcomes of this approach.
After single-port robotic approach was available at our institution, we prospectively followed our patients who underwent a single-port robotic cholecystectomy from March 2013 to May 2015 in our children's hospital.
There were 14 patients [female 11 (79%) versus male 3 (21%)], the average age was 12.20 ± 4.97 years, with a mean body mass index of 28.01 ± 8.57 m/kg. Of the 14 patients, 4 (29%) had cholelithiasis with choledocolithiasis and had undergone an endoscopic retrograde cholangiopancreatography before the operation, 6 (43%) had symptomatic cholelithiasis, and 4 (28%) had acute cholecystitis. The median operative room time was 125 minutes (range 60-202), the median time of operation was 77.5 minutes (range 64-169), the median estimated blood loss was 2 mL (range 2-25), and a median length of stay was 1 day (range 0-2). There were no conversions to another approach. The median follow-up was 7 months (range 3-22). One patient (7%) developed an umbilical port site seroma, which was managed conservatively, no other complications occurred.
Single-port robotic cholecystectomy is a feasible and safe approach for cholecystectomy in the pediatric population. More studies are required to compare it to different approaches.
对传统腹腔镜胆囊切除术进行改良旨在减轻腹痛并改善美容效果。单孔机器人胆囊切除术是一种安全可行的方法，在成人中已有报道，但儿童中的报道有限。本研究旨在报告我们在儿童中进行单孔机器人胆囊切除术的经验，并评估该方法的安全性、可行性和结果。
在我们机构可开展单孔机器人手术方法后，我们对2013年3月至2015年5月在我们儿童医院接受单孔机器人胆囊切除术的患者进行了前瞻性随访。
共有14例患者[女性11例（79%），男性3例（21%）]，平均年龄为12.20±4.97岁，平均体重指数为28.01±8.57m/kg。14例患者中，4例（29%）患有胆石症合并胆总管结石，术前接受了内镜逆行胰胆管造影，6例（43%）有症状性胆石症，4例（28%）有急性胆囊炎。中位手术时间为125分钟（范围60 - 202分钟），中位操作时间为77.5分钟（范围64 - 169分钟），中位估计失血量为2mL（范围2 - 25mL），中位住院时间为1天（范围0 - 2天）。无中转至其他手术方式的情况。中位随访时间为7个月（范围3 - 22个月）。1例患者（7%）出现脐部端口部位血清肿，经保守治疗，未发生其他并发症。
单孔机器人胆囊切除术是小儿胆囊切除术的一种可行且安全的方法。需要更多研究将其与不同手术方式进行比较。
