Abstract：
BACKGROUND: Robotic-assisted laparoscopy still lacks wide acceptance in infants and children. We developed the service and report the largest single institution experience of complications over a period of 11 years.
METHODS: Between March 2006 and May 2017, consecutive infants and children who underwent robotic assisted laparoscopy under the care of two laparoscopic surgeons were studied. Data for patients, surgeons, year of surgery, operation, and timing, nature, grades of complications were assessed.
RESULTS: A total of 601 robotic procedures (45 different types) were carried out in 539 patients. Of these 31 (5.8%) were converted, none for operative complications. These and another 4 with complicated co-morbidity were excluded, leaving 504 patients for further analysis. There were 60 (11.9%) complications in 57 (11.3%) patients. Mean (SD) age was 7.7 years -/+5.1 with the youngest being 4 weeks. Concomitant or bilateral robotic and non-robotic procedures took place in 8.1% and 13.3% of patients respectively. Significant medical co-morbidity and abdominal scarring were present in 29% and 14.9% of patients respectively. Complications occurred in theatre 1.6%, hospital 5.6%, 28 days 1.2%, and late 3.6%. Mean follow up was 7.6 years -/+ 3.1 SD. Over-all postoperative complication rate was 10.3%: CD grade I 6.5% (33), II 0.6% (3), and IIIa/b 3.2% (16) which included 1.4% (7) re-do surgery. Most (11/16) grade III occurred late. There were no bleeding, grade IV or V complications, surgical mortality, or technology related complications.
CONCLUSIONS: Complications are low even during the learning phase and while developing the new technique. Most complications occurred early and were minor. Most high-grade complications presented late.
METHODS: 2B.
METHODS: Between March 2006 and May 2017, consecutive infants and children who underwent robotic assisted laparoscopy under the care of two laparoscopic surgeons were studied. Data for patients, surgeons, year of surgery, operation, and timing, nature, grades of complications were assessed.
RESULTS: A total of 601 robotic procedures (45 different types) were carried out in 539 patients. Of these 31 (5.8%) were converted, none for operative complications. These and another 4 with complicated co-morbidity were excluded, leaving 504 patients for further analysis. There were 60 (11.9%) complications in 57 (11.3%) patients. Mean (SD) age was 7.7 years -/+5.1 with the youngest being 4 weeks. Concomitant or bilateral robotic and non-robotic procedures took place in 8.1% and 13.3% of patients respectively. Significant medical co-morbidity and abdominal scarring were present in 29% and 14.9% of patients respectively. Complications occurred in theatre 1.6%, hospital 5.6%, 28 days 1.2%, and late 3.6%. Mean follow up was 7.6 years -/+ 3.1 SD. Over-all postoperative complication rate was 10.3%: CD grade I 6.5% (33), II 0.6% (3), and IIIa/b 3.2% (16) which included 1.4% (7) re-do surgery. Most (11/16) grade III occurred late. There were no bleeding, grade IV or V complications, surgical mortality, or technology related complications.
CONCLUSIONS: Complications are low even during the learning phase and while developing the new technique. Most complications occurred early and were minor. Most high-grade complications presented late.
METHODS: 2B.
摘要：
背景：机器人辅助腹腔镜在婴儿和儿童中仍缺乏广泛的接受。我们开发了这项服务，并报告了11年来最大的单一机构并发症经验。
方法：在2006年3月至2017年5月之间，研究了在两名腹腔镜外科医生的护理下连续接受机器人辅助腹腔镜检查的婴儿和儿童。患者数据，外科医生,手术年份,操作,和时间,自然,评估并发症的等级.
结果：总共在539例患者中进行了601次机器人手术（45种不同类型）。在这31人(5.8%)中，没有手术并发症。这些和另外4例复杂的合并症被排除在外，留下504名患者进行进一步分析。57例（11.3％）患者中有60例（11.9％）并发症。平均（SD）年龄为7.7岁-/5.1，最小的为4周。伴随或双侧机器人和非机器人程序分别在8.1％和13.3％的患者中进行。29％和14.9％的患者分别存在明显的医学合并症和腹部疤痕。并发症发生在剧院1.6％，医院5.6%，28天1.2%，晚3.6%。平均随访时间为7.6年-/+3.1SD。术后总并发症发生率为10.3%：CDⅠ级6.5%(33)，II0.6%（3），IIIa/b为3.2%(16)，其中包括1.4%(7)的再次手术。大多数（11/16）III级发生晚。没有出血,IV级或V级并发症，手术死亡率,或技术相关的并发症。
结论：即使在学习阶段和开发新技术时，并发症也很低。大多数并发症发生在早期，且轻微。大多数高级别并发症出现较晚。
方法：2B。
方法：在2006年3月至2017年5月之间，研究了在两名腹腔镜外科医生的护理下连续接受机器人辅助腹腔镜检查的婴儿和儿童。患者数据，外科医生,手术年份,操作,和时间,自然,评估并发症的等级.
结果：总共在539例患者中进行了601次机器人手术（45种不同类型）。在这31人(5.8%)中，没有手术并发症。这些和另外4例复杂的合并症被排除在外，留下504名患者进行进一步分析。57例（11.3％）患者中有60例（11.9％）并发症。平均（SD）年龄为7.7岁-/5.1，最小的为4周。伴随或双侧机器人和非机器人程序分别在8.1％和13.3％的患者中进行。29％和14.9％的患者分别存在明显的医学合并症和腹部疤痕。并发症发生在剧院1.6％，医院5.6%，28天1.2%，晚3.6%。平均随访时间为7.6年-/+3.1SD。术后总并发症发生率为10.3%：CDⅠ级6.5%(33)，II0.6%（3），IIIa/b为3.2%(16)，其中包括1.4%(7)的再次手术。大多数（11/16）III级发生晚。没有出血,IV级或V级并发症，手术死亡率,或技术相关的并发症。
结论：即使在学习阶段和开发新技术时，并发症也很低。大多数并发症发生在早期，且轻微。大多数高级别并发症出现较晚。
方法：2B。
