Wang Huijuan, Zheng Zebing, Gan Yuanzhu, Liao Xilin, Du Qing, Liao Yu, Xia Xingrong, Zhu Daiwei, Tang Chenyan, Huang Lu, Zhou Wankang, Li Zeping, Gong Yuan, Liu Yuanmei, Jin Zhu
Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Pediatric Surgery, Guizhou Children's Hospital, Zunyi, China.
J Robot Surg. 2025 Jun 27;19(1):328. doi: 10.1007/s11701-025-02487-y.
The Da Vinci robot-assisted surgical technology signifies a substantial advancement in pediatric surgery for the treatment of congenital structural malformations. This research endeavor aims to perform a comprehensive comparative analysis of the therapeutic efficacy and assess the clinical applicability and value of the Da Vinci robot-assisted surgical method in relation to the conventional laparoscopic surgical technique, particularly in the management of congenital choledochal cysts. A retrospective cohort study was conducted involving 117 pediatric patients diagnosed with congenital choledochal cysts, who were admitted to the Affiliated Hospital of Zunyi Medical University between January 2019 and October 2024. Patients were categorized into two groups based on the surgical approach: the robot-assisted surgery group (RS group, n = 45) and the traditional laparoscopic surgery group (LS group, n = 72). Basic demographic and clinical data, perioperative parameters-including operation duration and intraoperative blood loss-and postoperative complications were systematically collected and statistically analyzed for both groups. The operating time in the robotic surgery (RS) group was 224.5 (203.3, 247.7) minutes, significantly longer than the 190.2 (170.5, 219.7) minutes recorded in the laparoscopic surgery (LS) group, with a statistically significant difference (P < 0.05). No conversions to open surgery occurred in either group. Intraoperative blood loss in the RS group was 11.5 (9.4, 13.4) ml, which was significantly less than the 19.8 (14.7, 26.6) ml observed in the LS group (P < 0.001). The postoperative drainage tube retention time was 4.5 (4, 6) days in the RS group compared to 5.8 (4, 7) days in the LS group, with a statistically significant difference (z = -3.285, P = 0.001). The postoperative hospital stay averaged 9 (7, 11) days for the RS group, while the LS group had an average of 11 (10, 13) days, also showing a statistically significant difference (z = -4.520, P < 0.001). During the follow-up period, complications were reported in 1 case [2.22% (1/45)] in the RS group, whereas 6 cases [8.33% (6/72)] were reported in the LS group. However, there was no statistically significant difference in complication rates between the two groups (P = 0.424). Robot-assisted treatment of congenital choledochal cysts is considered both safe and reliable. This technique minimizes the complexity of hepaticojejunal anastomosis and decreases the duration of the anastomosis. Furthermore, it provides several advantages, including reduced intraoperative blood loss, a low rate of postoperative complications, and a faster recovery period.
达芬奇机器人辅助手术技术标志着小儿外科在治疗先天性结构畸形方面取得了重大进展。本研究旨在对达芬奇机器人辅助手术方法与传统腹腔镜手术技术在治疗先天性胆总管囊肿方面的疗效进行全面比较分析,并评估其临床适用性和价值。对2019年1月至2024年10月期间遵义医科大学附属医院收治的117例诊断为先天性胆总管囊肿的儿科患者进行了一项回顾性队列研究。根据手术方式将患者分为两组:机器人辅助手术组(RS组,n = 45)和传统腹腔镜手术组(LS组,n = 72)。系统收集两组患者的基本人口统计学和临床数据、围手术期参数(包括手术时间和术中出血量)以及术后并发症,并进行统计学分析。机器人手术(RS)组的手术时间为224.5(203.3,247.7)分钟,显著长于腹腔镜手术(LS)组记录的190.2(170.5,219.7)分钟,差异有统计学意义(P < 0.05)。两组均未发生转为开放手术的情况。RS组术中出血量为11.5(9.4,13.4)ml,显著少于LS组观察到的19.8(14.7,26.6)ml(P < 0.001)。RS组术后引流管留置时间为4.5(4,6)天,而LS组为5.8(4,7)天,差异有统计学意义(z = -3.285,P = 0.001)。RS组术后平均住院时间为9(7,11)天,而LS组平均为11(10,13)天,差异也有统计学意义(z = -4.520,P < 0.001)。在随访期间,RS组报告1例并发症[2.22%(1/45)],而LS组报告6例[8.33%(6/72)]。然而,两组并发症发生率差异无统计学意义(P = 0.424)。机器人辅助治疗先天性胆总管囊肿被认为是安全可靠的。该技术最大限度地降低了肝空肠吻合的复杂性,缩短了吻合时间。此外,它还具有几个优点,包括减少术中出血量、术后并发症发生率低以及恢复期更快。