Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy

doi:10.3969/j.issn.1674-8115.2026.08.012

Abstract

Abstract:

Objective ·To compare and analyze the short-term effect of the Da Vinci robotic system and laparoscopy for the resection of mesenteric cyst in children. Methods ·A retrospective analysis was conducted on the clinical data of 71 children who underwent Da Vinci robotic-assisted or laparoscopic-assisted mesenteric cyst resection in the Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine between January 2020 and August 2025. Patients were divided into the Da Vinci group (n=33) and the laparoscopic group (n=38) based on surgical approach. Comparative analysis of baseline characteristics, operative time, intraoperative blood loss, mode of surgical completion, cyst location, maximum cyst diameter, postoperative fasting time, postoperative hospital stay, and postoperative complications was performed to evaluate the advantages and disadvantages of the two approaches. Results ·Baseline characteristics showed no statistically significant differences between the two groups in gender, age, weight, clinical symptoms, cyst location, or maximum cyst diameter (all P>0.05). Regarding the mode of surgical completion, all 33 patients (100%) in the Da Vinci group underwent complete intracavitary cyst dissection or bowel resection and anastomosis; only 3 patients (7.9%) in the laparoscopic group completed all procedures via an intracavitary approach, while the remaining patients required extraperitoneal completion of the procedure. The distribution of surgical completion modes differed significantly between the two groups (P<0.001). There were no statistically significant differences in operative time or postoperative fasting time between the two groups (both P>0.05). Intraoperative blood loss was significantly lower in the Da Vinci group than in the laparoscopic group [5 (2, 5) mL vs 6 (5, 10) mL, P<0.001], and postoperative hospital stay was also significantly shorter in the Da Vinci group [9 (7,11) d vs 10.5 (8,13) d, P=0.033]. No complications were observed in the Da Vinci group. In the laparoscopic group, one patient experienced intraoperative ureteral injury, and one developed postoperative chylous fistula. All patients were followed up for 6 months after discharge and achieved favorable recovery without cyst recurrence. Conclusion ·Compared with laparoscopic surgery, the Da Vinci robotic approach for pediatric mesenteric cyst resection markedly increases the rate of complete intracavitary procedures, with the merits of less intraoperative hemorrhage and faster postoperative recovery. It demonstrates reliable short-term efficacy and favorable safety.

Key words: mesenteric cyst, Da Vinci robotic system, laparoscopy, child

CLC Number:

R726.1

Chen Yi, Cai Duote, Xuan Xiaoxiao, Chen Sai, Chen Qingjiang, Gao Zhigang. Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(8): 1117-1123.

Figures/Tables 4

TrendMD

References 20

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Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Gender/n(%)			0.474
Male	21 (63.6)	21 (55.3)
Female	12 (36.4)	17 (44.7)
Age/month	63.0 (43.0, 85.0)	44.5 (22.5, 82.3)	0.185
Weight/kg	18.5 (15.2, 23.5)	14.8 (11.9, 21.0)	0.054
Symptomatic case/n(%)	26 (78.8)	28 (73.7)	0.615
Abdominal pain	23 (69.7)	23 (60.5)	0.420
Vomiting	9 (27.3)	12 (31.6)	0.585
Fever	8 (24.2)	8 (21.1)	0.748
Maximum diameter of cyst/cm	6.0 (5.0, 9.0)	8.0 (6.0, 10.3)	0.101
Mesenteric root cyst/n(%)	6 (18.2)	6 (15.8)	0.788
Cyst location/n(%)			0.928
Small intestine	24 (72.7)	28 (73.7)
Colon	9 (27.3)	10 (26.3)

Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Gender/n(%)			0.474
Male	21 (63.6)	21 (55.3)
Female	12 (36.4)	17 (44.7)
Age/month	63.0 (43.0, 85.0)	44.5 (22.5, 82.3)	0.185
Weight/kg	18.5 (15.2, 23.5)	14.8 (11.9, 21.0)	0.054
Symptomatic case/n(%)	26 (78.8)	28 (73.7)	0.615
Abdominal pain	23 (69.7)	23 (60.5)	0.420
Vomiting	9 (27.3)	12 (31.6)	0.585
Fever	8 (24.2)	8 (21.1)	0.748
Maximum diameter of cyst/cm	6.0 (5.0, 9.0)	8.0 (6.0, 10.3)	0.101
Mesenteric root cyst/n(%)	6 (18.2)	6 (15.8)	0.788
Cyst location/n(%)			0.928
Small intestine	24 (72.7)	28 (73.7)
Colon	9 (27.3)	10 (26.3)

Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Operative time/min	133.0 (85.0, 180.0)	111.5 (76.8, 150.5)	0.230
Blood loss/mL	5 (2, 5)	6 (5, 10)	<0.001
Surgical procedure^①/n(%)			<0.001
Cyst excision intracorporeally	12 (36.4)	3 (7.9)
Intestinal resection and anastomosis intracorporeally	21 (63.6)	0 (0)
Cyst excision extracorporeally	0 (0)	9 (23.7)
Intestinal resection and anastomosis extracorporeally	0 (0)	26 (68.4)
Postoperative fasting time/d	4 (3, 5)	4 (3, 5)	0.775
Postoperative hospital stay/d	9 (7, 11)	10.5 (8, 13)	0.033
Total cost/yuan	66 607 (58 985, 71 788)	19 715 (15 928, 27 726)	<0.001
Revised cost^②/yuan	22 306 (18 100, 26 751)	19 715 (15 928, 27 726)	0.152
Complication/n(%)	0 (0)	2 (5.26)	0.495
Postoperative recurrence/n(%)	0 (0)	0 (0)	>0.999

Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Operative time/min	133.0 (85.0, 180.0)	111.5 (76.8, 150.5)	0.230
Blood loss/mL	5 (2, 5)	6 (5, 10)	<0.001
Surgical procedure^①/n(%)			<0.001
Cyst excision intracorporeally	12 (36.4)	3 (7.9)
Intestinal resection and anastomosis intracorporeally	21 (63.6)	0 (0)
Cyst excision extracorporeally	0 (0)	9 (23.7)
Intestinal resection and anastomosis extracorporeally	0 (0)	26 (68.4)
Postoperative fasting time/d	4 (3, 5)	4 (3, 5)	0.775
Postoperative hospital stay/d	9 (7, 11)	10.5 (8, 13)	0.033
Total cost/yuan	66 607 (58 985, 71 788)	19 715 (15 928, 27 726)	<0.001
Revised cost^②/yuan	22 306 (18 100, 26 751)	19 715 (15 928, 27 726)	0.152
Complication/n(%)	0 (0)	2 (5.26)	0.495
Postoperative recurrence/n(%)	0 (0)	0 (0)	>0.999