Pham Hien Duy, Okata Yuichi, Vu Hoan Manh, Tran Nam Xuan, Nguyen Quang Thanh, Nguyen Liem Thanh
Department of Pediatric Surgery, Vietnam National Children's Hospital, 18/879 La Thanh, Dong Da, Hanoi, Vietnam.
Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Pediatr Surg Int. 2019 Nov;35(11):1211-1216. doi: 10.1007/s00383-019-04518-w. Epub 2019 Jul 3.
We aimed to describe our robotic-assisted surgery (RAS) techniques and assess the early results of RAS for choledochal cysts in children.
We conducted a retrospective chart review of children who underwent RAS for a congenital choledochal cyst at our institution between February 2013 and August 2016. We analyzed patient characteristics, operative data, and postoperative outcomes.
Thirty-nine patients underwent RAS for a choledochal cyst (female 30). The operation was performed with four robotic ports and one laparoscopic port for the assistant. The Roux loop was fashioned extracorporeally. Twenty patients (51.3%) had a Todani Type I cyst and the others had Type IV. The mean patient age and weight and choledochal cyst diameter at the time of the operation were 40.2 months (range 5-108 months), 13.4 kg (range 6.5-29 kg), and 27.2 mm (range 9-112 mm), respectively. The mean operating time was 192.7 min (range 150-330 min). There were no intraoperative complications; no conversions to laparoscopic or open surgery; and no postoperative complications, including cholangitis, cholelithiasis, or anastomotic stenosis.
Pediatric RAS CC resection is safe and feasible. The robot-assisted technique overcame technical difficulties. However, in pediatric cases, a skilled robotic surgical team and procedural modifications are needed.
我们旨在描述我们的机器人辅助手术（RAS）技术，并评估儿童胆总管囊肿RAS的早期结果。
我们对2013年2月至2016年8月期间在我院接受先天性胆总管囊肿RAS手术的儿童进行了回顾性病历审查。我们分析了患者特征、手术数据和术后结果。
39例患者接受了胆总管囊肿RAS手术（女性30例）。手术通过四个机器人端口和一个用于助手的腹腔镜端口进行。Roux袢在体外制作。20例（51.3%）患者为Todani I型囊肿，其他为IV型。手术时患者的平均年龄、体重和胆总管囊肿直径分别为40.2个月（范围5 - 108个月）、13.4千克（范围6.5 - 29千克）和27.2毫米（范围9 - 112毫米）。平均手术时间为192.7分钟（范围150 - 330分钟）。术中无并发症；无转为腹腔镜或开放手术的情况；术后也无并发症，包括胆管炎、胆石症或吻合口狭窄。
小儿RAS胆总管囊肿切除术是安全可行的。机器人辅助技术克服了技术难题。然而，在小儿病例中，需要熟练的机器人手术团队和手术方式的改进。
