Colin G. Knight, M.D.; Attila Lorincz, M.D.; Kelly Gidell, R.N., B.S.N.; Joseph Lelli, M.D.; Michael D. Klein, M.D.; Scott E. Langenburg, M.D.

The Maxine and Stuart Frankel Foundation Computer-Assisted Robot-Enhanced Surgery Program, the Children's Research Center of Michigan, and the Department of Pediatric Surgery at the Children's Hospital of Michigan, and the Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA

Abstract

Background/Purpose: Robotic surgery improves laparoscopic surgery through a more natural interface, tremor filtration, motion scaling, and additional degrees of freedom of the instruments. Our goal is to report our experience with robot-assisted fundoplication in children.

Methods: We identified 15 laparoscopic fundoplications done with the Zeus Robotic Surgery System and retrospectively reviewed prospectively collected data on set-up time, operative time, and outcome of operation.

Results: All cases were successfully completed: one Heller myotomy with Dor fundoplication and 14 Nissen fundoplications. Patients ranged from 10 months to 18 years old and from 3.7 kg to 37.7 kg (mean 13.0 kg). There were no technical errors, equipment errors, or conversions. We had no complications in the first 30 days following surgery. The operative time for each case declined from 323 minutes for the first case to 180 minutes for the last (average 195 minutes). The 14th case was the shortest at 123 minutes. Setting up the robotic surgery system took an average of 11 minutes. The surgeons' perceived benefits of greater ease and confidence in suture placement and knot tying.

Conclusion: We have successfully used surgical robotics for gastric fundoplications at a pediatric teaching hospital. Our experience with this laparoscopic operation has demonstrated the additional dexterity which the robot provides and will pave the way to more complex procedures.



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