Jin Yi, Zhang Shuhao, Cai Duote, Zhang Yuebin, Luo Wenjuan, Chen Ken, Chen Qingjiang, Gao Zhigang
Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Front Pediatr. 2023 Jun 19;11:1162236. doi: 10.3389/fped.2023.1162236. eCollection 2023.
The emergence of the robotic surgery system has assisted the further development of minimally invasive surgery by facilitating more delicate and precise complex procedures. The purpose of this study was to present a study of robot-assisted resection of the choledochal cyst and to discuss the technical points.
In total, 133 patients who were diagnosed with a choledochal cyst and underwent surgery from April 2020 to February 2022 in the Children's Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. The data were collected including the clinical information of the patients, operative details, and postoperative outcomes.
Among these 133 patients, 99 underwent robot-assisted surgery and 34 underwent laparoscopic assisted surgery. The median operation time was 180 min, with an interquartile range (IQR) of 170-210 min for the robot-assisted group and 180 min with an IQR of 157.5-220 min in the laparoscopic assisted group ( = 0.290). The detection rate of 82.5% for the distal opening of the cystic type of choledochal cyst was higher in the robot-assisted group than that in the laparoscopic assisted group at 34.8% ( = 0.000). The postoperative hospital stay was shorter ( = 0.009) and the hospitalization expense was higher ( = 0.000) in the robot-assisted group than that of the laparoscopic assisted group. There was no significant difference between the two groups in terms of complications, postoperative indwelling days of the abdominal drainage tube, intraoperative blood loss, and postoperative fasting time ( > 0.05).
Robot-assisted resection of choledochal cyst is safe and feasible, it is ideal for the patient requiring a meticulous operation, and its postoperative recovery was shorter than for traditional laparoscopy.
机器人手术系统的出现通过促进更精细和精确的复杂手术，辅助了微创手术的进一步发展。本研究的目的是介绍一项机器人辅助胆总管囊肿切除术的研究，并讨论技术要点。
回顾性分析2020年4月至2022年2月在浙江大学医学院附属儿童医院诊断为胆总管囊肿并接受手术的133例患者。收集的数据包括患者的临床信息、手术细节和术后结果。
在这133例患者中，99例行机器人辅助手术，34例行腹腔镜辅助手术。机器人辅助组的中位手术时间为180分钟，四分位数间距（IQR）为170 - 210分钟；腹腔镜辅助组的中位手术时间为180分钟，IQR为157.5 - 220分钟（P = 0.290）。机器人辅助组胆总管囊肿囊性类型远端开口的检出率为82.5%，高于腹腔镜辅助组的34.8%（P = 0.000）。机器人辅助组的术后住院时间较短（P = 0.009），但住院费用较高（P = 0.000）。两组在并发症、术后腹腔引流管留置天数、术中出血量和术后禁食时间方面无显著差异（P > 0.05）。
机器人辅助胆总管囊肿切除术安全可行，对于需要精细手术的患者是理想的选择，其术后恢复比传统腹腔镜手术更快。
