Yonsei Med J.  2015 May;56(3):737-743. 10.3349/ymj.2015.56.3.737.

Retrospective Assessment of the Validity of Robotic Surgery in Comparison to Open Surgery for Pediatric Choledochal Cyst

• Kim NY
• Chang EY
• Hong YJ
• Park S
• Kim HY
• Bai SJ
• Han SJ

• KMID: 2450348
• DOI: http://doi.org/10.3349/ymj.2015.56.3.737

Abstract

PURPOSE
We evaluated the validity of robotic surgery (RS) for pediatric choledochal cyst (CC) in comparison to open surgery (OS).
MATERIALS AND METHODS
From January 2009 to April 2013, clinical data from 79 consecutive pediatric patients with CC, who underwent RS (n=36) or OS (n=43) performed by a single pediatric surgeon, were analyzed retrospectively.
RESULTS
In the RS group, the age of the patients was significantly older, compared to the OS group. Operation and anesthesia times were significantly longer in the RS group than the OS group. Fluid input rates to maintain the same urine output were significantly smaller in the RS group than the OS group. The American Society of Anesthesiologists (ASA) physical status, length of postoperative hospital stay, and the incidence of surgical complications did not differ significantly between the two groups.
CONCLUSION
Although early complications could not be avoided during the development of robotic surgical techniques, RS for pediatric CC showed results comparable to those for OS. We believe that RS may be a valid and alternative surgery for pediatric CC. After further development of robotic surgical systems and advancement of surgical techniques therewith, future prospective studies may reveal more positive results.

Keyword

Choledochal cyst; robotic surgery; children

MeSH Terms

Age Distribution
Aged, 80 and over
Child
Child, Preschool
Choledochal Cyst/*surgery
Female
Humans
Incidence
Infant
Length of Stay/statistics & numerical data
Male
Minimally Invasive Surgical Procedures/*methods
Postoperative Complications/epidemiology
Postoperative Period
Prospective Studies
Reproducibility of Results
Retrospective Studies
*Robotics
Treatment Outcome

Figure

• 

  Fig. 1 Pain scores during 36 hours after surgery. Pain scores were measured using the Faces, Legs, Activity, Cry, and Consolability (FLACC, Score 0-2) Behavior Pain Assessment Tool designed for infants and a verbal numerical rating scale for pain (0=no pain and 10=worst pain imaginable) for children every 6 hours for 36 hours post-operatively. Box plot with median (solid line), interquartile range (box), and values within 1.5 times the interquartile range (whiskers). RS, robotic surgery for pediatric choledochal cyst; OS, open surgery for pediatric choledochal cyst.

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