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Comparative Study
. 2025 Jul 2;25(1):489.
doi: 10.1186/s12887-025-05811-5.

Comparative analysis of Da Vinci robotic surgery and laparoscopic surgery for congenital choledochal cyst in neonates

Xilin Liao  1   2 , Zebing Zheng  1   2 , Huijuan Wang  1   2 , Yu Liao  1   2 , Qing Du  1   2 , Lu Huang  1   2 , Chengyan Tang  1   2 , Yuan Gong  1   2 , Zeping Li  1   2 , Daiwei Zhu  1   2 , Yuanmei Liu  1   2 , Zhu Jin  3   4
Affiliations
Comparative Study

Comparative analysis of Da Vinci robotic surgery and laparoscopic surgery for congenital choledochal cyst in neonates

Xilin Liao et al. BMC Pediatr. .

Abstract

Objective: This study aims to compare and analyze the clinical efficacy and safety of Da Vinci robotic surgery (RS) versus traditional laparoscopic surgery (LS) for the treatment of congenital choledochal cyst (CCC) in neonates.

Methods: We retrospectively analyzed sixty-seven neonatal cases of CCC admitted to our hospital between December 2018 and December 2024. The cases were categorized into the robotic group (n = 32) and the laparoscopic group (n = 35) based on the surgical technique employed. We systematically compared baseline data, intraoperative metrics, and postoperative recovery between the two groups, focusing on total operative time, biliary-intestinal anastomosis time, and postoperative recovery outcomes.

Results: The two groups were comparable regarding baseline characteristics such as age, gender, weight, and cyst diameter (P > 0.05), with no significant differences in preoperative general conditions (P > 0.05); The total operative time was longer for RS compared to LS (208.54 ± 10.43 min vs. 194.54 ± 17.21 min, P = 0.016). However, the time required for biliary-intestinal anastomosis was shorter in RS (38.25 ± 9.78 min vs. 52.40 ± 9.83 min, P < 0.001), and intraoperative bleeding was significantly lower (P < 0.05); Postoperative abdominal drainage was significantly reduced in RS, with a shorter duration for drainage tube removal, demonstrating a statistically significant difference (P < 0.05). There was no statistically significant difference in the overall complication rate between the two groups.

Conclusion: Da Vinci robotic-assisted surgery is safe and feasible for the treatment of neonatal CCC. RS offers advantages such as a shorter biliary-intestinal anastomosis time, reduced tissue trauma, and faster recovery, warranting its promotion in neonatal surgical practices.

Trial registration: Retrospectively registered.

Keywords: Congenital choledochal cyst(CCC); Laparoscopic surgery(LS); Neonate; Robotic surgery (RS).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and other relevant regulations, approved by the Ethics Committee of Zunyi Medical University (Ethical Review Approval No.: KLL-2025-032), and informed consent was obtained from the children’s families. Informed consents to participate in the study have been obtained from participants and their legal guardians. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Robot-assisted surgery of choledochal cysts (A) MRCP indicates the location of choledochal cyst; (B) Ports arrangement; (C) Suspending the ligamentum teres hepatis and gallbladder fossa; (D) Extracorporeal jejunojejunostomy; (E) Dissecting and decompression the cyst; (F) Ldetaching the proximal end of the cyst and trimming the hepatic duct of the hilar part; (G) End-to-side hepaticojejunostomy; (H) Drainage tube placement
Fig. 2
Fig. 2
Laparoscopic surgery of choledochal cysts (A) Suspension of the round hepatic igament; (B) Exposing the cyst; (C) Peeling off the cyst; (D) End-to-side hepaticojejunostomy
See this image and copyright information in PMC

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