Robotic-assisted laparoscopic Malone appendicostomy: a 6-year perspective.
Pediatr Surg Int
; 40(1): 58, 2024 Feb 24.
Article
in En
| MEDLINE
| ID: mdl-38400936
ABSTRACT
PURPOSE:
A robotic-assisted laparoscopic approach to appendicostomy offers the benefits of a minimally invasive approach to patients who would typically necessitate an open procedure, those with a larger body habitus, and those requiring combined complex colorectal and urologic reconstructive procedures. We present our experience performing robotic-assisted appendicostomies with a focus on patient selection, perioperative factors, and functional outcomes.METHODS:
A retrospective review of patients who underwent a robotic-assisted appendicostomy/neoappendicostomy at our institution was performed.RESULTS:
Twelve patients underwent robotic-assisted appendicostomy (n = 8) and neoappendicostomy (n = 4) at a range of 8.8-25.8 years. Five patients had a weight percentile > 50% for their age. Seven patients underwent combined procedures. Median operative time for appendicostomy/neoappendicostomy only was 185.0 min. Complications included surgical site infection (n = 3), stricture requiring minor operative revision (n = 2), conversion to an open procedure due to inadequate appendiceal length (prior to developing our technique for robotic neoappendicostomies; n = 1), and granuloma (n = 1). At a median follow-up of 10.8 months (range 1.7-74.3 months), 91.7% of patients were consistently clean with antegrade enemas.DISCUSSION:
Robotic-assisted laparoscopic appendicostomy and neoappendicostomy with cecal flap is a safe and effective operative approach. A robotic approach can potentially overcome the technical difficulties encountered in obese patients and can aid in patients requiring both a Malone and a Mitrofanoff in a single, combined minimally invasive procedure.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Laparoscopy
/
Fecal Incontinence
/
Robotic Surgical Procedures
Language:
En
Journal:
Pediatr Surg Int
Year:
2024
Type:
Article
Affiliation country:
United States