Comparative of Robotic-Assisted versus Laparoscopic-Assisted Modified Soave Pull-Through with Short Muscular Cuff Anastomosis in Infants Under 3 Months with Classical Hirschsprung Disease
In brief
Robotic pull-through shortened surgery by 29 minutes in infants with Hirschsprung disease
In a retrospective comparison of 35 infants under 3 months, robotic surgery took about 29 minutes less than laparoscopic surgery and was linked to less blood loss and shorter hospital stays. Enterocolitis occurred in none of 19 robotic patients versus 4 of 16 laparoscopic patients, but the small, nonrandomized study cannot establish that robotics caused better outcomes.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 9 October 2026
- Study design
- Non-randomized / quasi-experimental trial
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Bo Wang, Chengyan Tang, Xinrong Xia, Yuan Gong, Qing Du, Daiwei Zhu, et al.
- PMID
- 42854893
- DOI
- 10.1016/j.jpedsurg.2026.163453
Why clinicians should know about it
- Picked for Pediatric Surgery (top studies of the week, 11 October 2026): Robotic vs laparoscopic HSCR, operative time shorter
Abstract
OBJECTIVE: To compare the clinical efficacy of robotic-assisted versus laparoscopic-assisted modified Soave pull-through with short muscular cuff anastomosis in infants under 3 months of age with classical Hirschsprung's disease (HSCR). METHODS: A retrospective analysis was conducted on 35 infants under 3 months with classical HSCR who underwent radical surgery at our hospital from January 2020 to December 2024. Among them, 19 underwent robotic-assisted surgery (robotic group), and 16 underwent laparoscopic-assisted surgery (laparoscopic group). Baseline characteristics, perioperative outcomes, postoperative complications, and defecation function were compared between the two groups. RESULTS: Baseline characteristics were comparable between groups (P > 0.05). Compared with the laparoscopic group, the robotic group had significantly shorter total operative time [(142.5±16.8) min vs. (171.3±24.6) min; P < 0.05], shorter anal dissection time [(20.8±5.2) min vs. (36.7±9.8) min; P < 0.05], less intraoperative blood loss [(6.5±2.4) ml vs. (11.0±5.6) ml; P < 0.05], and shorter postoperative hospital stays [(7.2±1.6) d vs. (8.9±2.4) d; P < 0.05]. The incidence of postoperative enterocolitis was significantly lower in the robotic group [0(0%) vs. 4(25.0%); P < 0.05]. Regarding defecation function, the robotic group showed fewer daily soiling episodes [(0.8±0.6) vs. (1.6±0.9); P < 0.05] and higher Kelly scores [(2.9±0.3) points vs. (2.4±0.7) points; P < 0.05]. No significant differences were observed between the two groups in terms of anastomotic complications, need for constipation intervention, daily bowel movement frequency, or excellent rate of defecation function (P > 0.05). CONCLUSION: In this non-randomized, retrospective comparison, robotic-assisted modified Soave pull-through with short muscular cuff anastomosis was found to be safe and feasible for infants under 3 months with classical HSCR. The robotic approach was associated with shorter operative time, reduced intraoperative blood loss, shorter hospital stays, and may be associated with improved mid-term defecation function compared with laparoscopic assistance.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.