Reasons and preventive strategies of conversions into open surgery during pediatric Da Vinci ro-botic surgery:a report of 581 cases at a single center
Objective To explore the reasons of conversions into open procedure during pediatric Da Vinci robot surgery(DVRS)and to propose preventive strategies.Methods From October 2020 to December 2022,the relevant clinical data were retrospectively reviewed for 581 children of a single disease undergoing DVRS.There were 325 boys and 256 girls with an average age of(4.00±3.52)years and an age range of 1 day to 16 years and 10 months.There were 11 neonates,145 infants,132 toddlers,141 preschoolers,137 school-age children and 15 adolescents.Height(body length)was(97.65±28.11)(45.00-175.00)cm and average weight(17.11±11.22)(2.00-67.00)kg.According to patient age and lesion location,puncture layout was selected as linear,fan-shaped or triangular.Operative duration,intraoperative volume of blood loss and conversion rate were compared.Results There was no perioperative mortality.Operative duration was(186.76±94.81)min and intraoperative volume of blood loss(5,10)(1-300)ml.Among them,7 cases were converted into open surgery.The reasons for conversion included invasion of important surrounding tissues and organs(ribs,descending main artery,trachea)(n=3),limited operating space(n=2)and intraoperative hemorrhage(n=2).No statistically significant difference existed in transition rate among different age groups(x2=1.18,P=0.947).Conclusion Pediatric DVRS is feasible.The most common reasons for conversions into open surgery are invasion of important surrounding tissues and organs,limited operating space and intraoperative hemorrhage.Accurately assessing patient's own space,lesion range,relationship with surrounding tissues,blood supply sources and controlling concurrent infectionare essential for lowering the conversion rate of pediatric DVRS.
Robotic surgical proceduresConversion into open surgeryPediatric surgery
万方数据
维普
