Robotic matches laparoscopic surgery in choledochal cyst management

In children who had had choledochal cysts, management with robotic and laparoscopic surgery leads to comparable outcomes, a recent study has found.

The study included 22 patients (median age 40 months) whose cysts were associated with aberrant hepatic ducts. Fourteen patients underwent laparoscopic surgery while the remaining eight were treated with robotic surgery. Baseline characteristics were comparable between groups.

Laparoscopic and robotic surgery had comparable rates of transfusion (7.14 percent vs 0.00 percent, respectively; p=0.0463) and conversion to open surgery (14.29 percent vs 0.00 percent, respectively; p=0.165). Similarly, the overall rate of complications did not differ between the surgical techniques (14.29 percent vs 12.50 percent, respectively; p=0.912).

Only three episodes of complications occurred. Two cases of bile leakage in the laparoscopic arm and one case of intestinal obstruction in the robotic arm.

Reoperation rates were likewise unaffected by surgical technique (p=0.336).

In contrast, operation time (p<0.001), anaesthesia use (p<0.001), intraoperative blood loss (p=0.015), time to water intake (p=0.035), and postoperative hospital stay (p=0.036) were all significantly better with robotic surgery.

“Robotic surgery can achieve the same results as laparoscopic surgery in the management of patients [who] suffered from choledochal cysts associated with aberrant hepatic duct, at the same time reducing the difficulty of operation and recovering faster,” the researchers said.