Colorectal Robotic-Assisted Surgery in Children. Long-Term Outcomes and Pitfalls.

Background: Colorectal surgical procedures may benefit from a minimally invasive approach in children, although there are few studies.

Methods: A retrospective, single-centre observational study was conducted on paediatric patients who underwent colorectal robotic-assisted surgery between 2011 and 2022.

Results: A total of 50 patients (33 male; 17 female) were included, with a median age of 4.

Robotic-assisted versus laparoscopic splenectomy in children: a costeffectiveness study.

Laparoscopic elective splenectomy is considered as a safe surgical treatment of spleen non-traumatic blood disorders. However, robotic assisted splenectomy is becoming a promising alternative, although there are scarce studies in pediatric patients. Our aim is to compare the effectiveness and associated costs of both procedures in children.

Acellular flowable dermal matrix for ostomy reconstruction: a safe and effective minimally invasive technique.

Background: Acellular dermal matrices have long been used for complex abdominal wall closure and, more recently, for ostomy reconstruction.

Purpose: To describe ostomy reconstruction with acellular flowable dermal matrix (AFDM) in a pediatric patient with a complex abdominal wall defect.

Case Report: A 14-year-old female who was diagnosed with unspecific hemorrhagic colitis at age 6 months and who underwent several abdominal surgeries (including total colectomy and terminal ileostomy) reported frequent, severe periostomy skin ulcerations secondary to improper fitting and ostomy bag leakage due to multiple periostomy skin retraction as a result of multiple abdominal scars.

Robotic-assisted vs. Laparoscopic Heller's Myotomy for Achalasia in Children.

Introduction: Robotic-assisted Heller-Dor procedure has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia in children. Our aim is to compare the effectiveness, safety and associated costs between both procedures.

Methods: A retrospective single center study was conducted among consecutive children operated for achalasia (Heller-Dor operation) between 2005 and 2021, who were divided into two groups according to the surgical approach: laparoscopic (LAP-group) or robotic (ROB-group).

Simultaneous Robotic-Assisted Splenectomy and Cholecystectomy in Children: Is It Safe and Effective?

Hematologic conditions such as hereditary spherocytosis, sickle cell disease, and idiopathic thrombocytopenic purpura are frequently linked to cholelithiasis. In instances where symptoms are present, simultaneous cholecystectomy and splenectomy are commonly recommended. Our aim was to assess the outcomes of robotic-assisted procedures conducted for simultaneous surgical issues involving the spleen and gallbladder in pediatric patients.

Neutrophil-to-lymphocyte ratio as a predictor of postoperative complications and readmissions after appendectomy in children.

To analyze the role of neutrophil-to-lymphocyte ratio (NLR) in predicting the development of postoperative complications and readmission after appendectomy in children. A retrospective single-centered case-control study was conducted on children who underwent appendectomy between 2017 and 2020. Demographics, time since symptoms onset, laboratory tests at admission, postoperative complications, and readmissions in the first 30 days after surgery were recorded.

Mucosal appendicitis: How can it be differentiated from nonappendicitis?

Objectives: Mucosal appendicitis is defined by neutrophilic infiltration limited to the mucosa, with no transmural invasion; it is currently a controversial entity. The aim of our study was to determine whether mucosal appendicitis represents an early stage of acute appendicitis (AA) or should be considered a negative appendectomy.

Methods: A retrospective study was performed of children with suspected AA who underwent surgical treatment between 2017 and 2020.

The Role of Indocyanine Green in Pediatric Gastrointestinal Surgery: Systematic Review.

The use of near-infrared fluorescence imaging with indocyanine green (ICG) is actually considered as a very useful tool in decision-making strategy during challenging surgical procedures with a growing evidence in the literature. Our aim is to perform a systematic review focusing on ICG applications in gastrointestinal surgery. We conducted a systematic review with narrative synthesis in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Medline, and EMBASE databases to identify articles describing the gastrointestinal perioperative use of ICG in children.

Robotic-assisted versus laparoscopic redo antireflux surgery in children: A cost-effectiveness study.

Introduction: Robotic-assisted redo fundoplication has some advantages compared to the laparoscopic approach in adults, although to date there are no studies in children.

Methods: A retrospective case-control study was performed among consecutive children who underwent redo antireflux surgery between 2004 and 2020, divided into two groups: LAF group (laparoscopic redo-fundoplication) and RAF group (robotic-assisted redo-fundoplication). Demographics, clinical, intraoperative, postoperative and economic data were compared.

How does the number of training years in pediatric surgery affect appendectomy outcomes?

Introduction: Appendectomy has traditionally been considered as a training operation for junior pediatric surgeons during their training period. However, with the increase of laparoscopic appendectomy, there has been a growing concern about the performance of this procedure by junior trainees. Our aim is to analyze intra-/postoperative appendectomy outcomes according to the number of training years during Pediatric Surgical residency training program.

Neutrophil-to-Lymphocyte Ratio as a Predictor of the Need for Surgical Treatment in Children's Intussusception.

Objective:  Neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory marker in abdominal pathologies. Ileocolic intussusception (ICI) involves a progressive intestinal inflammation, and the effectiveness of nonsurgical treatment (enema) might be related to the inflammation degree, although no previous studies have investigated this relationship. Our aim is to identify predictors of the need for surgical treatment in ICI.

Surgical Treatment of Bilateral Tubo-Ovarian Abscess in a Pre-Coitarchal Female.

Tubo-ovarian abscess (TOA) is a complication of pelvic inflammatory disease that is most commonly seen in sexually active females and seldom in pre-coitarchal adolescents. Initial treatment is generally parenteral antibiotics but often requires more invasive surgical procedures. We present the case of a 12-year-old, non-sexually active adolescent, with bilateral TOA who ultimately underwent a sterilizing bilateral salpingectomy and appendectomy for treatment.

A Rare Dual Diagnosis of Duodenal and Biliary Atresia in a Premature Infant.

We present a case of a baby conceived via in vitro fertilization and born prematurely with duodenal atresia. It was later discovered that the patient also had biliary atresia. Both defects were repaired surgically via duodeno-duodenostomy and Kasai procedures, respectively.

Robotic Soave pull-through procedure for Hirschsprung's disease in children under 12-months: long-term outcomes.

Purpose: To describe the long-term outcomes of the robotic Soave pull-through (RSPT) procedure for Hirschsprung's disease (HSCR) in children younger than 12 months.

Methods: A prospective observational study was conducted on HSCR patients under 12 months of age who underwent RSPT at our institution between 2011 and 2020. Data regarding demographics, clinical features, technical details, operative time, hospital stay, postoperative complications, and long-term outcomes were prospectively collected.

Education and training in pediatric robotic surgery: lessons learned from an inaugural multinational workshop.

The introduction of robotic surgery into clinical practice brings new and specific needs for education and training. Application to the pediatric setting comes with unique considerations, warranting dedicated training resources that are accessible. A pediatric robotic surgery workshop was convened to address initial education and training requirements.

Papillary thyroid cancer in identical adolescent twins with osteogenesis imperfecta and Hashimoto's thyroiditis: is there a genetic link?

The relationship between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC) remains controversial. Researchers have identified multiple genes that could put patients with HT at risk for PTC. None are related to osteogenesis imperfecta (OI).

A novel technique for the surgical treatment of achalasia in children: evaluated with postoperative esophageal manometry.

Introduction: The current surgical treatment for achalasia in the pediatric population is the laparoscopic Heller myotomy with or without a fundoplication. Although medical management with serial dilations and botulism toxin injections may offer short-term benefits, surgical therapy offers definitive treatment. In this article, we propose a modified surgical technique that avoids pitfalls associated with the standard procedure and evaluated our results with postoperative manometry.

A pure Sertoli cell tumor of the ovary in a 10-year-old female.

Study Objective: To document an unusual presentation of a pure Sertoli Cell tumor.

Design: Case report.

Results: We present a 10-year-old female who presented with abdominal pain and diarrhea with no symptoms of puberty.