WOFAPS 2025 8th World Congress of Pediatric Surgery

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Oral Presentation - 37

ROBOTIC-ASSISTED PULL-THROUGH PROCEDURES FOR HIRSCHSPRUNG’S DISEASE - A SYSTEMATIC REVIEW.

Shilpa Sharma 1, Vinod Raj 2, Viji G 3
1 All India Institute of Medical Sciences, New Delhi
2 MGM Medical College and Superspeciality Hospital, Indore, INDIA
3 VMMC and Safdarjang Hospital, New Delhi

AIM: To study the published literature on robotic-assisted pull-through procedures for Hirschsprung’s disease

METHOD - A PubMed search was done on 10th April 2024 with the words "robotic AND Hirschsprung’s disease". The articles were screened for relevance. Data was compiled on the role of robotic-assisted pull-through procedures in complex Hirschsprung's surgeries, comparison with laparoscopic-assisted procedures, benefits of one over the other, with emphasis on safety and feasibility of robotic-assisted procedures in children below one year of age. The search was updated on 10th July 2025.

RESULTS - The first; updated search gave 22;28 articles. 21 duplicated articles were excluded. 21 relevant studies were selected for the study. The most common robotic-assisted pull-through was Soave’s while Swenson’s was popular among Chinese studies. There were two studies with more than 100 cases in each. Mean age was less than 12 months in 7 studies. The most anomaly operated was classical rectosigmoid Hirschsprung’s disease. Few studies had long segment Hirschsprung’s while one study also treated total colonic aganglionosis robotically. All studies except one had a primary pull-through while the exception reported the use of robotic assistance in redo cases. There were no major intraoperative complications reported in any of the studies and no conversion to open laparotomies. The follow-up duration was less than 12 months in 4 studies. Incontinence scores were reported in the follow-up period among 4 studies.

CONCLUSION- The current advancement in robotic surgeries reflects continuous improvement in safety, efficacy, and patient outcomes. The transition to minimally invasive robotic surgery underscores not only a reduction in operative times and postoperative complications but also a notable enhancement in the quality of life for pediatric patients.

Keywords: HD, Robotic Surgery, Colorectal

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