{"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> = 0.017). The greatest efficiency gains were observed at the second (<i>P</i> = 0.041) and final stitches (<i>P</i> = 0.041). Complication rates were comparable between the two groups (<i>P</i> = 0.986).</p><p><strong>Conclusion: </strong>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.</p>","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}
Learning curve comparison of robot-assisted and laparoscopic hepaticojejunostomy: a focus on critical suturing.
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.
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.
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