ROBOT-ASSISTED APPENDECTOMY IN A CHILD – A CASE REPORT

Introduction. The aim of this study was to investigate the possibility of performing robotic appendectomy in children in emergency cases and to assess its feasibility at this age and to provide a review of the literature on this topic.

Material and methods. The authors of this study conducted a retrospective review of the medical history of a child with acute appendicitis. A 11-year-old boy was admitted to the Irkutsk State Regional Children's Clinical Hospital with abdominal pain in the right iliac region. At the time of admission, the duration of the disease was 20 hours. The operation was performed using the Versius robot manufactured by CMR company (UK). Robot-assisted appendectomy followed the same principles as those used in open or laparoscopic approaches: (1) exposure of the appendix, (2) bipolar coagulation of the mesoappendix, (3) removal of the appendix using an endoscopic mechanical stapler.

Results. The total operative time was 30 minutes, of which the robot installation time was 10 minutes, and the main console time was 20 minutes. The entire procedure was performed completely intracorporeally and without conversion to laparoscopic or open surgery. The procedure was performed successfully without intraoperative difficulties and complications. Enteral feeding of the patient was started on the same day after the operation. The patient was discharged from the department on the 3rd day after the operation. Ultrasound of the abdominal cavity, performed 1 month after the operation, did not reveal any signs of abnormalities observed at this age. The patient did not complain of any digestive complaints during the entire observation period of 3 months after the surgery.

Conclusion. Thus, robotic appendectomy has its advantages and disadvantages in the treatment of acute appendicitis. Robotics provides faster postoperative recovery for patients, but requires more time to perform the surgery and is expensive. Over time, robot-assisted appendectomy may become a cost-effective procedure that will be successfully used by all surgeons, as happened with laparoscopic appendectomy several decades ago