Robot-assisted abdominal surgery in children less than 5 months of age: retrospective cohort study

Background: Robot-assisted surgery is increasingly used in children. While robot-assisted surgery in children has been proved to be safe and feasible, use in infants is controversial. The purpose of this study was to present a study of robot-assisted abdominal surgery in children less than5 months of age. Materials and methods: A retrospective analysis of 111 patients less than 5 months of age who underwent abdominal surgery from April 2020 to December 2022 in our hospital. The data included clinical information, operative details, and postoperative outcomes. Results: Among these 111 patients, 67 underwent robot-assisted surgery and 44 underwent laparoscopic-assisted surgery, the robot-assisted group includes 40 patients with Hirschsprung disease, 20 patients with choledochal cysts, and 7 patients with intestinal duplication, the laparoscopic-assisted group includes 26 patients with Hirschsprung disease, 9 patients with choledochal cysts, and 9 patients with intestinal duplication. For Hirschsprung disease, the operation time was significantly longer (P=0.013) and the intraoperative bleeding was significantly less (P=0.000) in the robot-assisted group than the laparoscopic assisted group. For choledochal cysts, the median operation time of 180 mins for the robot-assisted group was not significantly longer than the laparoscopic assisted surgery group at 160 mins (P=0.153). For intestinal duplication, the operation time was significantly longer (P=0.002) in the robot-assisted group than the laparoscopic assisted group. For these three diseases, the hospitalization expense was significantly higher (P<0.05) in the robot-assisted group than the laparoscopic assisted group, there were no significant differences in complications, and postoperative fasting time between two groups (P>0.05). Conclusion: Robot-assisted abdominal surgery in children less than 5 months of age is safe and feasible. This study showed that the surgical indications for the Da Vinci robot system in children can be extended to infants.