Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Evaluation of the Learning Curve of Freehand Transperineal Prostate Biopsy Performed Under Local Anesthesia.","authors":"Ali Emre Fakir, Alper Bitkin, Mithat Ekşi, Azad Akdağ, Mehmet Karadağ, Ahmet Koşargelir, Serdar Karadağ, Hakan Polat, Taner Kargı, Ali İhsan Taşçı","doi":"10.1177/10926429261481659","DOIUrl":"https://doi.org/10.1177/10926429261481659","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the learning curve (LC) of office-based freehand transperineal prostate biopsy (f-TPBx) performed under local anesthesia and its correlation with the operator experience.</p><p><strong>Methods: </strong>A total of 176 patients who underwent f-TPBx between June and November 2023 were retrospectively analyzed. The first 44 cases of four different physicians (2 consultant urologists and 2 urology residents) were included, and patients were stratified into quartiles (Q1-Q4). The LC was assessed based on differences in procedure time, fibromuscular core rates, cancer detection rates, and complication rates across quartiles. A multivariate analysis was performed to identify factors affecting procedure time. LC of consultant urologists and urology residents was compared.</p><p><strong>Results: </strong>There was a significant reduction in procedure duration across quartiles (Q1: 22.3 ± 4.2 minutes versus Q4: 13.7 ± 4.1 minutes; <i>P</i> < .001), alongside an increase in clinical significant prostate cancer detection rates (<i>P</i> = .034). Fibromuscular core rates significantly decreased, and overall complication rates declined over time (both <i>P</i> = .001). It has been observed that the LC for consultant urologists was completed after approximately 20 cases. Cumulative SUM and locally weighted scatterplot smoothing analyses demonstrated that consultant urologists reached the plateau phase earlier. According to multivariate regression analysis, quartile variable were among the factors significantly affecting procedure time (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The LC for f-TPBx appears to plateau after approximately 20 cases, suggesting that stable procedural performance can be achieved within a relatively short period. The technique provides notable advantages, including high patient comfort, a strong safety profile, and rapid learnability, which support its successful integration into clinical practice.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261481659"},"PeriodicalIF":1.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Versus Laparoscopic Paraesophageal Hernia Repair: A Propensity Score-Matched Analysis of Perioperative and Long-Term Outcomes.","authors":"Goro Ueda, Taha Qaraqe, Shiwei Han, Erik Stiles, Joel Sternbach, MadhanKumar Kuppusamy, Donald E Low, Michal Hubka","doi":"10.1177/10926429261481877","DOIUrl":"https://doi.org/10.1177/10926429261481877","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical (MIS) techniques, including laparoscopic (LAP) and robotic-assisted (ROBOT) approaches, have become the preferred methods for managing paraesophageal hernias (PEH). However, differences in clinical outcomes between these techniques remain an area of active investigation. This study aims to compare symptom resolution and key outcomes, including recurrence rates, between robotic and LAP PEH repair using propensity score matching (PSM) in a high-volume surgical center.</p><p><strong>Methods: </strong>Patients who underwent PEH repair between 2000 and 2023 (<i>n</i> = 1834) were retrospectively analyzed. All patients were prospectively enrolled in an IRB-approved database. Among them, those who underwent robotic or LAP PEH repair were specifically selected for comparison. PSM was performed using 1:1 nearest-neighbor matching (ROBOT: <i>n</i> = 128. LAP: <i>n</i> = 128). Patient demographics, hernia characteristics, operative techniques, and postoperative outcomes were assessed. The primary outcomes included symptom improvement, radiographical recurrence, and need for revisional intervention.</p><p><strong>Results: </strong>After PSM, patients undergoing robotic PEH repair showed no significant difference in symptom improvement compared with the LAP group-particularly for dysphagia, heartburn, and regurgitation-compared with the LAP approach. However, the overall symptom improvement rate was higher in the ROBOT group. Radiographic recurrence was higher in the robotic group in univariable analysis. However, multivariable Cox regression analysis did not identify the surgical approach as an independent predictor of recurrence-free survival. Furthermore, both approaches showed good perioperative outcomes, with similar length of stay and complication rates.</p><p><strong>Conclusion: </strong>Robot-assisted PEH repair was associated with symptom relief and perioperative outcomes comparable to LAP repair. Although radiographic recurrence was higher in the ROBOT group, Cox regression analysis did not identify the surgical approach as an independent predictor of recurrence. These findings suggest that operative technique and patient selection may play an important role in long-term outcomes after PEH repair.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261481877"},"PeriodicalIF":1.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Peritoneal-Dominant Recurrence After Robot-Assisted Radical Cystectomy for Urothelial Carcinoma.","authors":"Yasushi Nozaki, Masakazu Abe, Keita Ogasawara, Moe Toyoshima, Daiki Ikarashi, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Wataru Obara","doi":"10.1177/10926429261481656","DOIUrl":"https://doi.org/10.1177/10926429261481656","url":null,"abstract":"","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261481656"},"PeriodicalIF":1.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tack Number as an Independent Predictor of Recurrence after TEP Repair: A Multicenter Retrospective ROC-Based Study.","authors":"Kerem Özgü, Mehmet Onur Gül, Ercan Korkut, Deniz Kütük, Mehmet Süha Sevinç, Akın Fırat Kocaay","doi":"10.1177/10926429261481657","DOIUrl":"https://doi.org/10.1177/10926429261481657","url":null,"abstract":"<p><strong>Background: </strong>Mesh fixation during totally extraperitoneal (TEP) inguinal hernia repair remains controversial, and the optimal number of fixation tacks required to balance recurrence risk and postoperative recovery has not been clearly defined. This study aimed to assess the influence of tack quantity on recurrence, chronic pain, and return to daily activities after TEP repair.</p><p><strong>Methods: </strong>This multicenter retrospective study included 412 patients who underwent laparoscopic TEP repair between January 2023 and March 2025. Recurrence, chronic pain, and time to return to daily activities were evaluated. Receiver operating characteristic (ROC) analysis was performed to explore a potential threshold for recurrence risk. To avoid bias related to data-derived dichotomization, the number of tacks was included as a continuous variable in multivariable logistic regression analysis adjusting for hernia diameter, hernia type, and laterality.</p><p><strong>Results: </strong>Recurrence occurred in 30 patients (7.3%). ROC analysis suggested four tacks as a potential threshold for recurrence risk (AUC = 0.68). Patients receiving fewer than four tacks had higher recurrence rates than those receiving four or more tacks (11.6% versus 3.6%, <i>P</i> = .002). In multivariable analysis, hernia diameter (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.02-1.15; <i>P</i> = .012), direct hernia type (OR 3.79, 95% CI: 1.55-9.26; <i>P</i> = .004), and bilateral repair (OR: 7.92, 95% CI: 2.85-22.02; <i>P</i> < .001) were independent predictors of recurrence. Higher tack number was independently associated with lower recurrence odds (OR: 0.79, 95% CI: 0.64-0.97; <i>P</i> = .023). Chronic pain scores did not differ significantly between groups, whereas return to daily activities was slightly earlier in patients receiving fewer tacks.</p><p><strong>Conclusion: </strong>A higher number of fixation tacks was independently associated with lower recurrence risk after TEP repair. These findings suggest that fixation strategy should be individualized, with stronger fixation considered particularly in large direct or bilateral hernias.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261481657"},"PeriodicalIF":1.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Rectopexy for Pediatric Rectal Prolapse: Implementation, Technique, and Outcomes from a Single Institution.","authors":"William Law, Prathima Nandivada, Mark A Fleming, Emily Schumann, Ada Nicodemus, Belinda Dickie","doi":"10.1177/10926429261479934","DOIUrl":"https://doi.org/10.1177/10926429261479934","url":null,"abstract":"<p><strong>Purpose: </strong>A robotic approach to rectopexy for rectal prolapse improves ease of lower pelvic dissection, visualization, and ergonomics for the surgeon. We present our experience with implementation, technique, and outcomes of robotic rectopexy for children with rectal prolapse.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent robotic rectopexy from May 2019 to January 2026 at our institution was performed.</p><p><strong>Results: </strong>Eleven cases of rectal prolapse were included with 10 (90.9%) patients who had chronic constipation. The median age was 15.8 years (11.1, 17.5) and weight was 45.0 kg (38.1, 49.6). Four patients (36.4%) had previous abdominal surgery. Preoperatively, 5 patients (45.5%) required manual reduction of prolapse, 11 patients (100%) trialed stool softeners, 6 (54.5%) underwent pelvic floor physical therapy, and 7 (63.6%) had previous sclerotherapy. The median operative time was 235.0 minutes (201.5, 305.0). The median hospital length of stay was 3.0 days (1.5, 3.5) with no complications or deaths at 30 days. All patients demonstrated resolution over median 2.0 months (0.9, 13.7) of follow up.</p><p><strong>Conclusion: </strong>The use of the robotic platform in pediatric rectopexy for rectal prolapse is feasible and safe with high rates of resolution in the short term.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261479934"},"PeriodicalIF":1.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trifecta Outcomes in Pediatric Pyeloplasty: A Comparative Analysis of Standard Versus Mini-Laparoscopic Techniques.","authors":"Önder Özden, Mehmet Necmettin Mercimek, Murat Gülşen, Ertuğrul Köse, Şaban Sarıkaya, Ender Özden","doi":"10.1177/10926429261481279","DOIUrl":"https://doi.org/10.1177/10926429261481279","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study was to compare perioperative and functional outcomes between conventional laparoscopic pyeloplasty (CLP) and mini-laparoscopic pyeloplasty (MLP) in pediatric patients. As a secondary objective, we evaluated a composite trifecta outcome, defined as a structured summary measure rather than a validated endpoint.</p><p><strong>Methods: </strong>This retrospective study included 129 pediatric patients (<18 years) who underwent CLP (<i>n</i> = 67) or MLP (<i>n</i> = 62) between August 2009 and February 2025. Trifecta success was defined as a composite outcome comprising: (1) a ≥14 mm reduction in AP pelvic diameter, (2) absence of obstruction on postoperative scintigraphy, and (3) absence of postoperative complications. Univariate logistic regression analysis was performed to identify predictors of trifecta success.</p><p><strong>Results: </strong>The mean age was 7.2 ± 5.8 years, and 33.3% of patients were female. Operative time was significantly longer in the CLP group (113 ± 35.5 versus 90.6 ± 26.2 minutes; <i>P</i> = .001), whereas anastomosis time was comparable between groups (<i>P</i> = .152). Minor complications occurred in 16.5% of patients. Receiver operating characteristic analysis demonstrated that a reduction in AP diameter ≥14 mm predicted trifecta success, with an AUC of 0.659, sensitivity of 52.8%, and specificity of 80%. Overall, trifecta success was achieved in 76.7% of patients, with no significant difference between CLP and MLP (74.6% versus 79%, <i>P</i> = .677). Logistic regression analysis did not identify any significant predictors of trifecta success, including surgical technique (odds ratio [OR] 1.528, <i>P</i> = .361).</p><p><strong>Conclusion: </strong>CLP and MLP are safe and effective approaches with comparable perioperative and functional outcomes. The proposed trifecta criteria may provide a structured framework for outcome assessment; however, external validation is warranted. Future prospective multicenter studies incorporating patient-reported outcomes are needed to better define the clinical impact of instrument miniaturization in pediatric urology.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261481279"},"PeriodicalIF":1.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Complications in Laparoscopic Surgery in Ouagadougou.","authors":"Issa Wendpouiré Bahikoro, Aimée Florence Sanon, Daouda Bara, Amos Nitiema, Mamadou Windsouri, Rodrigue N Doamba, Carine S Bagré, Laure Clarisse S Yameogo, Gilbert P Bonkoungou, Fidèle W Sawadogo, Nélia Yacine Sanou, Marius Nedelcu, Adama Sanou","doi":"10.1177/10926429261479171","DOIUrl":"https://doi.org/10.1177/10926429261479171","url":null,"abstract":"<p><strong>Introduction: </strong>The expansion of indications for laparoscopic surgery is associated by an increase in morbidity that must be evaluated. The objective of the current study was to evaluate the postoperative complications of laparoscopic surgery in Ouagadougou.</p><p><strong>Methods: </strong>A retrospective descriptive cross-sectional study conducted over a 5-year period. All patients aged 15 years and older who underwent laparoscopic surgery in the general surgery departments of four health care facilities in Ouagadougou and who experienced postoperative complications were included.</p><p><strong>Results: </strong>Complications were recorded in 38 cases, representing 2.8% of the 1,377 laparoscopic surgical procedures performed. The study included 23 women and 15 men with a mean age of 42.6 years, and a male-to-female ratio of 0.68. The procedure was performed as an emergency in 65.8% of cases, and the most frequent indication for surgery was acute appendicitis (12 cases). The mean time to onset of complication was 2.5 days. The complication was surgical site infection in 71.9% of cases. There was no mortality. The mean length of hospital stay was 9.5 days.</p><p><strong>Conclusion: </strong>Despite the current reported complications, especially infectious ones, laparoscopic surgery remains a preferred and recommended method in general surgery in Burkina Faso. Infection prevention measures must be strengthened to reduce this avoidable morbidity.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261479171"},"PeriodicalIF":1.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling Global Trends in Robot-Assisted Spleen-Related Surgery: A Comprehensive Bibliometric Analysis.","authors":"Linru Yang, Jin Liu, Chenglou Zhu","doi":"10.1177/10926429261478792","DOIUrl":"https://doi.org/10.1177/10926429261478792","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the global research landscape, knowledge structure, collaboration networks, research hotspots, and emerging trends of robot-assisted spleen-related surgery (RAS) through bibliometric analysis.</p><p><strong>Methods: </strong>English-language original articles and reviews related to RAS were retrieved from the Web of Science Core Collection, including the Science Citation Index Expanded (SCI- Expanded) and Social Sciences Citation Index (SSCI), for the period from January 1, 2005, to December 31, 2025. Bibliometric analyses and visualizations were performed using CiteSpace, VOSviewer, and BiblioVista to assess publication trends, citation patterns, collaboration networks, leading contributors, keyword co-occurrence, clustering, cocitation, and burst references.</p><p><strong>Results: </strong>A total of 130 publications were included. Annual output showed a fluctuating upward trend, especially after 2014, and peaked in 2023. Surgical Endoscopy was the most productive and influential journal. The United States led in publication output, Italy showed the strongest overall citation performance, and Yonsei University and its affiliated health system were leading institutions. Major themes included robotic surgery, laparoscopic splenectomy, distal pancreatectomy, minimally invasive surgery, partial splenectomy, spleen preservation, learning curve, complications, and perioperative outcomes. Hotspots evolved from early feasibility and safety assessment toward complex pancreaticosplenic procedures, functional preservation, perioperative optimization, and precision minimally invasive surgery.</p><p><strong>Conclusion: </strong>RAS research has progressed from technical exploration toward complex, precision-oriented, and function-preserving applications. Future studies should strengthen multicenter collaboration and further evaluate long-term outcomes, cost-effectiveness, and standardized surgical strategies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261478792"},"PeriodicalIF":1.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Management for Unilateral Vesicoureteral Reflux: Comparison of Endoscopic Injection Versus Transvesicoscopic Cohen Reimplantation.","authors":"Keerthika Murali, Vvs Chandrasekharam","doi":"10.1177/10926429261479314","DOIUrl":"https://doi.org/10.1177/10926429261479314","url":null,"abstract":"<p><strong>Objective: </strong>Surgical intervention techniques to correct unilateral vesicoureteral reflux (VUR) are advocated to prevent recurrent urinary tract infections and further renal damage. Although unilateral ureteral reimplantation is highly successful, new contralateral reflux (NCVUR) can develop postoperatively in some patients. The purpose of this study was to review and analyse the outcomes of Endoscopic injection of dextranomer/hyaluronic acid (ET) and transvesicoscopic Cohen ureteral reimplantation (TVUR) in unilateral VUR, along with incidence and clinical outcomes of NCVUR.</p><p><strong>Methods: </strong>After IRB approval, the data of children that underwent ET (group 1) and TVUR (group 2) for unilateral VUR over a 6-year period was reviewed. Children with secondary and bilateral VUR, duplex kidneys, and no postoperative follow-up were excluded. Various parameters were compared between the two groups.</p><p><strong>Results: </strong>Ninety-eight children (42 group 1 and 56 group 2) were included. The mean grade of VUR was significantly higher in group 2 than group 1 (<i>P</i> < .001). Group 1 had significantly shorter operating time and hospital stay than group 2 (<i>P</i> = .0001), while group 2 had higher success (<i>P</i> = .007), although the clinical efficacy for grades 2 to 3 VUR was comparable in both groups. The overall incidence of NCVUR was 6%, with no significant difference between the groups (<i>P</i> = .715). During a mean follow-up of 36 months, all NCVUR were managed by observation only, with no renal damage or need for surgical intervention.</p><p><strong>Conclusions: </strong>TVUR was preferred by parents for higher grades of VUR with paraureteral diverticulum and had higher success. ET had lower morbidity, and for grades 2-3 VUR, ET and TVUR had comparable clinical efficacy. The overall incidence of NCVUR was low, with no increased risk of NCVUR after TVUR, and most NCVUR was benign and self-limiting.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261479314"},"PeriodicalIF":1.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Pancreaticoduodenectomy in Pediatric Patients: First Two Reported Cases in the United States.","authors":"Irving J Zamora, Jessica K Sims, Vikas S Gupta, Roshan J D'Cruz, Jillian Jacobson, Alejandro O Chara, Kevin N Johnson, Anthony M Gamboa, Daniel J Benedetti, Patricio M Polanco, Herbert J Zeh, Sekhar Padmanaban, Harold N Lovvorn, Samir Pandya","doi":"10.1177/10926429261478780","DOIUrl":"https://doi.org/10.1177/10926429261478780","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (Whipple procedure) is rarely required in children, but remains the standard of care for resectable pancreatic head tumors. Robotic pancreaticoduodenectomy (RPD) has been increasingly performed in adults, demonstrating safety, feasibility, and in some series, superior perioperative outcomes compared with open surgery. In children, however, there are only three published case reports worldwide.</p><p><strong>Methods: </strong>We describe two adolescent females with pancreatic head solid pseudopapillary neoplasms (SPNs) who underwent RPD at high-volume U.S.</p><p><strong>Centers: </strong>Both cases were managed by multidisciplinary teams including pediatric surgeons and adult surgical oncologists experienced in robotic pancreatic surgery.</p><p><strong>Results: </strong>Case 1: A 13-year-old underwent robotic pylorus-preserving pancreaticoduodenectomy utilizing intraoperative Indocyanine Green Firefly and ultrasound to assess critical anatomy. Reconstruction was performed with Blumgart pancreaticojejunostomy and hepaticojejunostomy. She advanced to diet by postoperative day (POD) 3 and was discharged on POD 3. Case 2: A 17-year-old underwent RPD with pylorus preservation in a similar fashion at an adult hospital. Her recovery was uncomplicated, drains were removed on POD 4, and she was discharged on POD 5. Final pathology in both patients confirmed SPN with negative margins.</p><p><strong>Conclusions: </strong>These represent the first pediatric RPDs reported in the United States and the first using the da Vinci Xi platform. Our experience demonstrates that pediatric RPD is feasible and safe when performed in collaboration with high-volume adult robotic pancreatic programs. Given the rarity of pediatric pancreatic tumors, collaborative registries and continued reporting are essential to define outcomes and guide best practice.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261478780"},"PeriodicalIF":1.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}