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Oral Presentation - 70
Robotic-Assisted Surgery with Modified Three-Port Multichannel System: Initial Experiences in Children with Choledochal Cyst
Boshen Shu, Shufeng Zhang, Jian Gao, Lin Wang, Xiaohui Wang
Department of Pediatric Surgery, Henan Provincial People’s Hospital, Zhengzhou, China
Purpose: The experiences of children with choledochal cyst (CDC) who undergo modified three-port multichannel robotic-assisted surgery are limited. We presented the experiences of 33 consecutive children with CDC to evaluate the efficacy and safety of this procedure.
Method: A total of 33 children who diagnosed with CDC and underwent modified three-port multichannel robotic-assisted excision combined with Roux-en-Y hepaticoenterostomy between 2022 and 2025 were enrolled. The same senior surgeon used the da Vinci (Xi) surgical system to perform these procedures. The clinical characteristics, efficacy and safety outcomes of short-term were detailed.
Results: We successfully completed surgical operations of 33 children (Girl: 25; Boy: 8) without conversion to open surgery and 2 cases had postoperative complications. The mean age was 25.6 ± 30.1 months (range 0.7–113.0) and the mean weight was 10.8 ± 5.8 kg (range 3.5–25.0). In accordance with Todani classification system, 20 cysts were type Ia, 9 cysts were type IVa and 4 cysts were type Ic. The mean diameter of the cysts was 32.7 ± 16.5 mm (range 12.6-79.0), while the mean operation time was 276.1 ± 27.5 min (range 220.0-325.0). The mean time to start semi-solid diet was 3.5 ± 1.0 days (range 2.0–6.0) after surgery, and the mean hospital stay was 6.4 ± 1.1 days (range 5.0–9.0). Subsequent follow-ups at 3 and 6 months exhibited no abnormalities, as confirmed through abdominal sonography and laboratory evaluations.
Conclusion: The modified three-port multichannel robotic-assisted surgery is safe and effective for children with CDC. The authors found the application of robotic-assisted surgical system can enhance controllability and visualization in the minimally invasive procedure. However, further research is necessary to validate these findings in larger pediatric populations and longer follow-ups.