Ishii Hiroki, Shirota Chiyoe, Tainaka Takahisa, Makita Satoshi, Satomi Miwa, Kato Daiki, Maeda Takuya, Ota Kazuki, Hinoki Akinari, Uchida Hiroo
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
J Robot Surg. 2024 Dec 27;19(1):34. doi: 10.1007/s11701-024-02181-5.
The advantage of robot-assisted surgery (RAS) is its ability to perform fine surgical operations with higher-resolution images. RAS should be particularly beneficial for small children, but it requires a certain amount of working space. The da Vinci Surgical System instructions state that careful consideration of indications for robotic surgery in patients weighing ≤ 10 kg is required. We aimed to investigate the safety and efficacy of RAS in pediatric patients weighing ≤ 10 kg with congenital biliary dilatation (CBD). Pediatric patients who underwent surgery for CBD at our institution were included. Patients were divided into three groups: the ≤ 10 kg group (RS-S) and the > 10 kg group (RS-L), both of which underwent robotic surgery, and another ≤ 10 kg group (LS-S), which underwent laparoscopic surgery. No patient required conversion to laparotomy. The operative duration was significantly shorter in the RS-S group than in the RS-L group. Intraoperative bleeding and length of hospital stay did not differ significantly between the RS-S and RS-L groups. Postoperative drain removal and hospital stay were shorter in the RS-S group than in the LS-S group. Our findings suggest that RAS can be safely and precisely implemented for infants weighing ≤ 10 kg.
机器人辅助手术（RAS）的优势在于其能够利用高分辨率图像进行精细的外科手术。RAS对小儿患者可能特别有益，但它需要一定的工作空间。达芬奇手术系统的说明书指出，对于体重≤10 kg的患者，需要仔细考虑机器人手术的适应症。我们旨在研究RAS在体重≤10 kg的先天性胆管扩张症（CBD）小儿患者中的安全性和有效性。纳入了在我们机构接受CBD手术的小儿患者。患者分为三组：体重≤10 kg组（RS-S）和体重>10 kg组（RS-L），两组均接受机器人手术，另一组体重≤10 kg组（LS-S）接受腹腔镜手术。没有患者需要转为开腹手术。RS-S组的手术时间明显短于RS-L组。RS-S组和RS-L组之间的术中出血量和住院时间没有显著差异。RS-S组的术后引流管拔除时间和住院时间比LS-S组短。我们的研究结果表明，RAS可以安全、精确地应用于体重≤10 kg的婴儿。
