Di Fabrizio Donatella, Bindi Edoardo, Nino Fabiano, Cobellis Giovanni
Pediatric Surgery Unit, Salesi Children's Hospital, 60123, Ancona, Italy.
Department of Specialized Clinical and Odontostomatological Sciences, University Politecnica of Marche, 60121, Ancona, Italy.
J Robot Surg. 2025 May 1;19(1):192. doi: 10.1007/s11701-025-02276-7.
Robotic surgery represents a groundbreaking advancement in modern surgery, offering precision, enhanced visualization, and reduced invasiveness. Robotic single-site surgery (RSSS), utilizing a single incision for access, combines these benefits with improved cosmetic outcomes, making it particularly appealing for pediatric patients. This systematic review evaluates the feasibility, clinical outcomes, and procedural details of RSSS in children.A systematic review was conducted using PRISMA guidelines, with searches across PubMed, Web of Science, Scopus, Medline, and Cochrane Library up to June 2024. Studies reporting on RSSS in pediatric patients were included, focusing on demographics, surgical details and outcomes such as conversion rate, blood loss, complications, reoperations, and hospital stay. Data extraction and quality assessment were independently conducted by reviewers using the Newcastle-Ottawa Scale.Seventeen studies with 322 pediatric patients were included. Procedures performed included cholecystectomy (54.7%), pyeloplasty (23.6%), choledochal cyst resection (7.4%), ureteral reimplantation (7.8%), and inguinal hernia repair (6.5%). The overall complication rate was 6% (minor complications, Clavien-Madadi grade I), with a conversion rate of 0.3% and no reoperations reported. Mean operative times varied by procedure, with minimal blood loss and short hospital stays.RSSS is a feasible and safe technique in pediatric surgery, demonstrating low complication and conversion rates. While it offers significant benefits in precision and cosmetic outcomes, further research is essential to optimize its application in pediatric surgical practice.
机器人手术代表了现代手术的一项突破性进展,具有精准性、增强的可视化效果和更低的侵入性。机器人单孔手术(RSSS)通过单一切口进行操作,将这些优势与改善的美容效果相结合,使其对儿科患者特别有吸引力。本系统评价评估了RSSS在儿童中的可行性、临床结果和手术细节。
使用PRISMA指南进行了系统评价,检索了截至2024年6月的PubMed、科学网、Scopus、Medline和Cochrane图书馆。纳入了关于儿科患者RSSS的研究,重点关注人口统计学、手术细节和结果,如转化率、失血量、并发症、再次手术和住院时间。评审人员使用纽卡斯尔-渥太华量表独立进行数据提取和质量评估。
纳入了17项研究,共322例儿科患者。实施的手术包括胆囊切除术(54.7%)、肾盂成形术(23.6%)、胆总管囊肿切除术(7.4%)、输尿管再植术(7.8%)和腹股沟疝修补术(6.5%)。总体并发症发生率为6%(轻微并发症,Clavien-Madadi I级),转化率为0.3%,未报告再次手术情况。平均手术时间因手术而异,失血量极少,住院时间短。
RSSS在儿科手术中是一种可行且安全的技术,并发症和转化率较低。虽然它在精准性和美容效果方面具有显著优势,但进一步的研究对于优化其在儿科手术实践中的应用至关重要。