Efficacy Of Robotic Surgical System For Adult Congenital Choledochal Cysts

Objective : To investigate the feasibility,security and efficacy of robot surgical system in resection of adult congenital choledochal cysts.Summarize the surgical procedures and operational skills.Methods:The clinical data of 4 patients who underwent choledochal cysts resection and Roux-en-Y hepaticojejunostomy with robotic surgical system from 2010 to 2014 were retrospectively analyzed.A comparative study was made between the 4 patients and another 12 patients who underwent laparotomic choledochal cysts resection and Roux-en-Y hepaticojejunostomy. We observe and compare the clinical and operative data of the two groups,then bring out a preliminary evaluation of the procedures in different methods.Results:All the operations by robot were successfully performed and none was converted to laparotomy.In the group of robotic surgery,the operation time was( 127.5±35.0) min( range from 90 to 170 min),and the intra-operation blood loss was(25.0±28.9)ml( range from 0 to 50 ml).No transfusion was needed during and after the operation.The postoperativehospital stay was(11.8±3.9)days( range from 8 to 16 days).In the group of laparotomic surgery,the operation time was(195±33.9)min( range from 150 to 250 min) and the intra-operation blood loss was(179.2±91.6)ml( range from 0 to 300 ml).No transfusion was needed during and after the operation.The postoperative hospital stay was(13.8±4.4)days( range from 9 to 24 days) in the group of laparotomic surgery.The robotic group was better in operation time and the volume of blood loss( P < 0.05).The follow-up time was from 5 to 31 months, and the patients were doing well with no relapse and complications.Conclusions:Robot-assisted resection of adult congenital choledochal cysts and Roux-en-Y hepaticojejunostomy is secure,feasible with the advantages of mini-invasive and quick recovery.The superiority remains to be confirmed by more cases and long-term follow-up.