Robot-Assisted Laparoscopic Fundoplications in Pediatric Surgery: Experience Review

Aurélien Binet; Laurent Fourcade; Sarah Amar; Khalid Alzahrani; Ann-Rose Cook; Karim Braïk; Jérôme Cros; Bernard Longis; Thierry Villemagne; Hubert Lardy; Quentin Ballouhey

doi:10.1055/s-0037-1615279

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2019; 29(02): 173-178
DOI: 10.1055/s-0037-1615279

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Robot-Assisted Laparoscopic Fundoplications in Pediatric Surgery: Experience Review

Aurélien Binet

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Laurent Fourcade

²Pediatric Surgery Unit, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

,

Sarah Amar

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Khalid Alzahrani

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Ann-Rose Cook

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Karim Braïk

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Jérôme Cros

²Pediatric Surgery Unit, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

,

Bernard Longis

²Pediatric Surgery Unit, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

,

Thierry Villemagne

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Hubert Lardy

¹Pediatric Surgery Unit, Centre Hospitalier Regional Universitaire de Tours, Tours, France

,

Quentin Ballouhey

²Pediatric Surgery Unit, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France

› Author Affiliations

Abstract

Introduction Laparoscopic fundoplicature for gastroesophageal reflux disease has become the gold standard because of the improvement of postoperative rehabilitation compared with the open procedure. The robot-assisted surgery has brought new advantages for the patient and the surgeon compared with laparoscopy. We studied this new approach and the learning curve.

Materials and Methods Sixty robot-assisted fundoplicatures were performed in two university pediatric surgery centers. Data of the patients were recorded, including peroperative data (operation length and complications), postoperative recoveries, and clinical evolution. The learning curve was evaluated retrospectively and each variable was compared along this learning curve.

Results We observed a flattening of the learning curve after the 20th case for one surgeon. The mean operative time decreased significantly to 80 ± 10 minutes after 20 cases. There were no conversions to an open procedure. A revision surgery was indicated for 4.7% of the patients by a surgical robot-assisted laparoscopic approach.

Conclusion The robotic system appears to add many advantages for surgical ergonomic procedures. There is a potential benefit in operating time with a short technical apprenticeship period. The setting up system is easy with a short docking time.

Keywords

robotics - laparoscopy - fundoplication - pediatric surgery

Full Text

References

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