Minimally Invasive Redo Pull-Throughs in Hirschsprung Disease

Prato, Alessio Pini; Arnoldi, Rossella; Faticato, Maria Grazia; Mariani, Narciso; Dusio, Maria Pia; Felici, Enrico; Tentori, Augusta; Nozza, Paolo

doi:10.1089/lap.2020.0250

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…After removing duplicates and title and abstract screening, 35 studies were assessed for eligibility through full-text evaluations. In the end, fifteen studies were considered eligible and included in the review ( Figure 1 ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five out of eight studies reported LOSs (3.5 to 7.8 days), and there were very limited data on readmissions and reinterventions. There were no IOCs reported, and only one conversion (3.0%) occurred in Meehan et al’s study [ 16 , 20 , 21 , 23 , 25 , 27 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies on robotic surgery for paediatric gastrointestinal diseases. RSC = retrospective single-centre; PSC = prospective single-centre; PMC = prospective multi-centre; NA = Not Applicable; IQR = Interquartile range; ARM = anorectal malformation[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

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confidence: 99%

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Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Duhoky,

Claxton,

Piozzi

et al. 2024

Children

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Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and recent developments in the reductions in port sizes and single-port surgery offer promising prospects. This study aimed to present a systematic overview and analysis of the existing literature around the use of robotic platforms in the treatment of paediatric gastrointestinal diseases. Materials and Methods: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale. Results: Fifteen studies were included, of which seven were on Hirschsprung’s disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, p < 0.001), but no significant differences in blood loss, length of stay, intraoperative complications, postoperative complications, or conversion. Conclusions: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Duhoky,

Claxton,

Piozzi

et al. 2024

Children

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“…43,44 There are very few reports of robotic bowel surgery in children. Redo pull-through in Hirschsprung disease was reported to have a significantly lower complication rate after RALS (6%) compared with the open approach (21%), 45 whereas the feasibility of coloproctectomy, and ileal J-pouch in children was associated with a complication rate of 30%. 46 In surgical oncology, no robot-specific complications were noted in our study and the 3 most common complications were pleural or collection drainage and intestinal obstruction.…”

Section: Discussionmentioning

confidence: 97%

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Vinit

Vatta²,

Broch³

et al. 2023

Annals of Surgery

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To report one-year morbidity of robotic-assisted laparoscopic surgery (RALS) in a dedicated, multidisciplinary, pediatric robotic surgery program. Summary Background Data. RALS in pediatric surgery is expanding, but data on morbidity in children is limited. Methods: All children who underwent RALS (Da Vinci Xi, Intuitive Surgical, USA) were prospectively included (October 2016 to May 2020; follow-up ≥1 year). Analyzed data: patient characteristics, surgical indication/procedure, intraoperative adverse events (ClassIntra classification), blood transfusion, hospital stay, postoperative complications (Clavien-Dindo). Results: Three hundred consecutive surgeries were included: urology/ gynecology (n=105), digestive surgery (n=83), oncology (n=66), ENT surgery (n=28), thoracic surgery (n=18). Median age and weight at surgery were 9.5 [interquartile range (IQR)=8.8] years and 31 [IQR=29.3] kg, respectively. Over one year, 65 (22%) children presented with ≥1 complication, with Clavien-Dindo ≥III in 14/300 (5%) children at ≤30 days, 7/300 (2%) at 30-90 days, and 12/300 (4%) at >90 days. Perioperative transfusion was necessary in 15 (5%) children, mostly oncological (n=8). Eight (3%) robotic malfunctions were noted, one leading to conversion (laparotomy). Overall conversion rate was 4%. ASA ≥3, weight ≤15 kg, and surgical oncology did not significantly increase the conversion rate, complications, or intraoperative adverse events (ClassIntra ≥2). ASA score was significantly higher in children with complications (Clavien-Dindo ≥III) than without (p=0.01). Median hospital stay was 2 [IQR=3] days. Three children died after a median follow-up of 20 [IQR=16] months. Conclusions: RALS is safe, even in the most vulnerable children with a wide scope of indications, age, and weight. Robot-specific complications or malfunctions are scarce.

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“…In 2017, Mattioli et al reported three cases of robot-assisted Soave procedures for HSCR in children aged 5 years, 16 years and 20 months 32. According to the postoperative follow-up data of different centers, the clinical results of RAS are satisfactory, with no postoperative incontinence, good defecation function, and a low incidence of postoperative enterocolitis 32–35…”

Section: Application Of Ras In Pediatric Surgerymentioning

confidence: 99%

Application and prospects of robotic surgery in children: a scoping review

Shen

Tou

2022

World Jnl Ped Surgery

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As an innovative minimally invasive surgical technology, robot-assisted surgery (RAS) has greatly improved the accuracy and safety of surgery through the advantages of three-dimensional magnification, tremor filtering, precision and flexibility, and has been carried out by an increasing number of surgeries. In recent years, robots have been gradually applied to children, bringing new ideas and challenges to pediatric surgeons. This review will describe the advantages and limitations of robotic surgery in children, summarize its application in pediatric surgery, and provide an outlook. It is believed that clinicians should actively carry out RAS under the premise of rigorously ensuring surgical indications and strive to improve the efficacy of surgical treatment for children.

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Minimally Invasive Redo Pull-Throughs in Hirschsprung Disease

Cited by 10 publications

References 20 publications

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

Adverse Events and Morbidity in a Multidisciplinary Pediatric Robotic Surgery Program. A prospective, Observational Study

Application and prospects of robotic surgery in children: a scoping review

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