Robotic-Assisted Pyloromyotomy

Abstract

Objective

: Robotic surgical systems have emerged as new tools in miniature access surgery. Feasibility in animal models has been demonstrated, however safety in infants has not. The purpose of this study was to evaluate the safety and feasibility of the addition of a robotic surgical system to a commonly performed laparoscopic procedure in infants.

Methods

: Eleven infants undergoing laparoscopic pyloromyotomy (LP) in 2001 were compared with 6 infants undergoing robotic-assisted pyloromyotomy (RP) in 2002. Data collected included age, post-operative temperature change, operative time, anesthesia time, and operative complications. Results are reported as mean with standard deviation. Statistical significance (defined as p < 0.05) was determined using the Student's t-test.

Results

: There was a statistically significant difference in operative and anesthesia times. Operative time for LP was 33.9 ± 6.9 minutes, for RP, 61.5 ± 11.9 minutes (p = 0.002). Anesthesia time was 94.4 ± 8.93 minutes for LP, 137 ± 22.9 minutes for RP (p = 0.007). There were no statistically significant differences between the two groups in age, LP 5.8 ± 2.27 weeks, RP 5 ± 6.16 weeks (p = 0.86); post-operative stay, LP 4 ± 4.88 days, RP 6.16 ± 11.55 days (p = 0.7); postoperative temperature change LP 0.15 ± 1.83°F, RP 1.1 ± 0.7°F, (p = 0.09); or complications (none in either group). The median postoperative hospital stays were 1.0 day (RP) and 1.5 days (LP).

Conclusion

: Although there was no direct benefit to the robotic group, there was no clinically significant difference between the groups and there were no complications or safety issues in the robotic group. These findings support the addition of robotic technology for more advanced surgical procedures in infants and children where its strengths, such as microsurgical precision, improved visualization, and ergonomic positioning, may be more pronounced.