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. 2023 Sep 26;23(1):294.
doi: 10.1186/s12893-023-02169-2.

Comparation of robotic-assisted surgery and laparoscopic‑assisted surgery in children with Hirschsprung's disease: a single-centered retrospective study

Shuhao Zhang  1 , Duote Cai  1 , Yuebin Zhang  1 , Tao Pan  1 , Ken Chen  1 , Yi Jin  1 , Wenjuan Luo  1 , Zongwei Huang  1 , Di Hu  1 , Qingjiang Chen  1 , Zhigang Gao  2
Affiliations

Comparation of robotic-assisted surgery and laparoscopic‑assisted surgery in children with Hirschsprung's disease: a single-centered retrospective study

Shuhao Zhang et al. BMC Surg. .

Abstract

Background: There are few studies comparing robotic-assisted surgery (RAS) and laparoscopic-assisted surgery (LAS) in Hirschsprung's disease (HSCR). This study aimed to compare intraoperative and postoperative outcomes between RAS and LAS performed during the same period.

Methods: All consecutive 75 patients with pathologically diagnosed as HSCR who underwent Swenson pull-through surgery from April 2020 to Nov 2022, were included. Patients were divided into RAS group and LAS group and a retrospective analysis was performed based on clinical indexes and prognosis.

Results: A total of 75 patients were included, among which, 31 patients received RAS and 44 received LAS. The RAS and LAS groups had similar ages, sex, weight, postoperative hospital stays, and fasting times. Compared with LAS, blood loss (p = 0.002) and the incidence of Hirschsprung-associated enterocolitis (p = 0.046) were significantly lower in the RAS group. The first onset of Hirschsprung-associated enterocolitis in patients younger than 3 months occurred significantly earlier (p = 0.043). Two patients experienced anastomotic leakage in the LAS group and one patient experienced incisional hernia in the RAS group. The cost of RAS was significantly higher than that of LAS (p < 0.0001).

Conclusions: RAS is a safe and effective alternative for HSCR children, and a delaying primary surgery until later in infancy (> 3 months) may improve outcomes.

Keywords: Enterocolitis; Hirschsprung’s disease; Laparoscopic-assisted surgery; Robotic-assisted surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Robotic programs of different surgical positions and port placements. A and C: Program of Upper abdominal location. B and D: Program of pelvic location. c is camera port (12 mm), a and b are working ports (8 mm)
Fig. 2
Fig. 2
Intraoperative photographs of incisional hernia in RAS group. A The incarcerated intestine. B The re-sutured robotic surgical incision. C Necrosis was not seen in the incarcerated intestine
Fig. 3
Fig. 3
Intraoperative photographs of RAS and LAS. A and B The amplified and high-definition visualizations of pelvic floor and peritoneal reflection in RAS. C and D The accurate monopolar bleeding control in RAS. Red arrows point to the bleeding point. E and F Intraoperative photographs of LAS showed relatively unclear surgical field and poor identification of seromuscular
See this image and copyright information in PMC

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