Da Vinci Robotic System for Pediatric Surgery: Report of First 20 Cases

Abstract

OBJECTIVE The Da Vinci robotic surgery system offers particular advantages and is currently a frontier study in the field of minimally invasive surgery. In this study, we retrospectively reviewed our experience in robotic surgical system in pediatric surgery as a tertiary referral center. We hope this pilot study can offer some recommendation for future development. METHODS Since 2007 to 2012, a total of 20 robotic-assisted operations(F: 10;M: 10) have been performed. The average age of the patient was 10.7 y(ranged from 3 to 18 y). The operations included 9 cases of fundoplication (one of them also underwent robotic assisted Heller’s operation for achalasia at the same time), 5 cases of pyeloplasty, 2 cases of excision of choledochal cyst, 2 cases of partial esophagectomy, 1 case of ureteric reimplantation, and 1 case of Mitrofanoff procedure. RESULTS The mean operation time of fundoplication and pyeloplasty were respectively 220.1 and 204.2 minutes. 0ne patient who underwent choledochal cyst excision was converted to open surgery due to difficult dissection. Disease recurrence was noted in one patient with partial esophagectomy for congenital esophageal stenosis due to tracheo-esophageal remnant. CONCLUSION The Da Vinci robotic sugical system is a reliable and effective approach for pediatric surgery. Long-term follow-up study is needed for further evaluation of its efficacy.

目的達芬奇機器人手術系統具有獨特的優勢,是當前微創外科手術的前沿領域。本文通過回顧分析和總結我中心在機器人輔助下完成小兒外科手術資料,為今后深入開展機器人小兒外科手術提供經驗和參考。方法 2007～2012年,我中心累積采用機器人輔助完成小兒外科手術20例(男女各10例;平均年齡10.7歲)。手術包括9例胃底折疊術、5例腎盂成形術、2例膽總管囊腫切除術、2例食管部分切除術、1例輸尿管膀胱再植術和1例可控性尿流改道術。結果 9例胃底折疊平均手術時間為220.1 min,5例腎盂成形平均手術時間為204.2 min。1例膽總管囊腫術中因組織分離困難而中轉開腹。1例先天性食管狹窄伴食管氣管瘺行食管部分切除術后2周復發,經二次手術治愈。結論機器人手術是小兒微創外科治療的有效手段。仍需對患兒長期隨訪,以進一步評估機器人手術的遠期效果。