Learning curve comparison of robot-assisted and laparoscopic hepaticojejunostomy: a focus on critical suturing.

IF 2.1 3区医学 Q2 PEDIATRICS

Frontiers in Pediatrics Pub Date : 2025-03-18 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1558362

Jiahui Liu, Takuya Maeda, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Yousuke Gohda, Yoichi Nakagawa, Aitaro Takimoto, Yaohui Guo, Daiki Kato, Akihiro Yasui, Akinari Hinoki, Hiroo Uchida

{"title":"Learning curve comparison of robot-assisted and laparoscopic hepaticojejunostomy: a focus on critical suturing.","authors":"Jiahui Liu, Takuya Maeda, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Yousuke Gohda, Yoichi Nakagawa, Aitaro Takimoto, Yaohui Guo, Daiki Kato, Akihiro Yasui, Akinari Hinoki, Hiroo Uchida","doi":"10.3389/fped.2025.1558362","DOIUrl":null,"url":null,"abstract":"Background: Robot-assisted surgery (RS) has gained popularity due to its potential advantages over conventional laparoscopic surgery (LS). However, the specific suturing steps that benefit most from RS in terms of efficiency remain unclear. This study aimed to compare the suturing performance and learning curves of RS and LS during hepaticojejunostomy.Methods: We retrospectively analyzed surgical videos of patients who underwent hepaticojejunostomy performed by the same surgeon between 2016 and 2023. Cases with incomplete data or conversion to open surgery were excluded. Suturing efficiency, anastomotic precision, and learning curves were evaluated using standardized metrics.Results: A total of 33 patients were included in the final analysis (17 RS, 16 LS). The median suture time per stitch was significantly shorter in the RS group (P = 0.017). The greatest efficiency gains were observed at the second (P = 0.041) and final stitches (P = 0.041). Complication rates were comparable between the two groups (P = 0.986).Conclusion: RS significantly improves efficiency at challenging suturing steps and provides a more consistent learning curve, highlighting its potential advantage for complex pediatric procedures such as hepaticojejunostomy. Future multicenter studies with larger sample sizes and longer follow-up are needed to validate these results and explore long-term outcomes.","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1558362"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958166/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1558362","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Robot-assisted surgery (RS) has gained popularity due to its potential advantages over conventional laparoscopic surgery (LS). However, the specific suturing steps that benefit most from RS in terms of efficiency remain unclear. This study aimed to compare the suturing performance and learning curves of RS and LS during hepaticojejunostomy.

Methods: We retrospectively analyzed surgical videos of patients who underwent hepaticojejunostomy performed by the same surgeon between 2016 and 2023. Cases with incomplete data or conversion to open surgery were excluded. Suturing efficiency, anastomotic precision, and learning curves were evaluated using standardized metrics.

Results: A total of 33 patients were included in the final analysis (17 RS, 16 LS). The median suture time per stitch was significantly shorter in the RS group (P = 0.017). The greatest efficiency gains were observed at the second (P = 0.041) and final stitches (P = 0.041). Complication rates were comparable between the two groups (P = 0.986).

Conclusion: RS significantly improves efficiency at challenging suturing steps and provides a more consistent learning curve, highlighting its potential advantage for complex pediatric procedures such as hepaticojejunostomy. Future multicenter studies with larger sample sizes and longer follow-up are needed to validate these results and explore long-term outcomes.

查看原文本刊更多论文

背景：与传统腹腔镜手术（LS）相比，机器人辅助手术（RS）因其潜在优势而广受欢迎。然而，从效率上来说，RS最受益的具体缝合步骤仍不清楚。本研究旨在比较 RS 和 LS 在肝空肠吻合术中的缝合效果和学习曲线：我们回顾性分析了 2016 年至 2023 年期间由同一外科医生实施肝空肠吻合术的患者的手术视频。排除了数据不完整或转为开放手术的病例。使用标准化指标对缝合效率、吻合精度和学习曲线进行评估：共有 33 例患者纳入最终分析（17 例 RS，16 例 LS）。RS 组每次缝合的中位缝合时间明显缩短（P = 0.017）。第二针（P = 0.041）和最后一针（P = 0.041）的缝合效率最高。两组的并发症发生率相当（P = 0.986）：RS明显提高了高难度缝合步骤的效率，提供了更一致的学习曲线，突出了其在肝空肠吻合术等复杂儿科手术中的潜在优势。未来需要进行样本量更大、随访时间更长的多中心研究，以验证这些结果并探讨长期疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.