BACKGROUND
Cholecystectomy is one of the most common surgical procedures performed in a minimally invasive way.
OBJECTIVE
Demonstration of the first experience of performing robot-assisted cholecystectomies in children with cholelithiasis and analysis of its results.
MATERIAL AND METHODS
The study presents retrospective data on 3 patients with cholelithiasis operated on using robot-assisted technology at the Irkutsk State Regional Children’s Clinical Hospital. The study was approved by the hospital’s local ethics committee. Robot-assisted gallbladder removal procedures were performed using the new Versius robot model manufactured by CMR (Cambridge Medical Robotics, UK) using 4 ports.
RESULTS
The mean age of patients at the time of surgery was 16.7±0.6 years (median 17.0 [16.5; 17.0] years). The mean weight of patients at the time of surgery was 56.5±4.9 kg (median 55.0 [53.8; 58.5] hg). The smallest body weight of a child who underwent a robot-assisted operation was 52.6 kg. The duration of the operation was 65.0±5.0 min (median 65.0 [62.5; 67.5] min). During the surgical intervention, there were no complications in the form of bleeding from the cystic artery or damage to the common bile or right bile ducts. The content of the gallbladder was in all cases bile with gallstones of different diameters from 2 to 12 mm in it. Histological examination revealed signs of chronic inflammation of the gallbladder wall. The duration of stay of patients in the intensive care unit was 19.7±1.5 hours (median 20.0 [19.0; 20.5] hours). Duration of hospitalization was 4.7±1.5 (median 5.0 [4.0; 5.5] days). An extract for outpatient observation was carried out after a control ultrasound, which demonstrated the absence of accumulation of pathological exudate in the bed of the removed gallbladder. Throughout the observation period, patients did not complain of discomfort and pain in the area of the upper floors of the abdominal cavity. According to the ultrasound examination performed 1, 3 and 6 months after the operation, there were no signs of expansion of the external and internal bile ducts.
CONCLUSION
Robotic cholecystectomy is a reproducible minimally invasive technique in children. It is well accepted by patients and their parents as a safe and cosmetically beneficial surgical procedure. Further research is needed to determine the potential benefit of using this approach in pediatric surgery.
