Robot-Assisted Soave Procedure Improves Outcomes in Hirschsprung Disease: BMC study

A new study published in the journal of BMC Surgery revealed that robot-assisted modified Soave procedure with short muscular cuff anastomosis results in shorter anal dissection time, fewer anastomotic complications, and improved defecation function in patients with classical Hirschsprung disease (HSCR).

Children with HSCR may be more susceptible to pelvic plexus damage due to inadequate rectum mobilization, which might raise the incidence of postoperative problems. However, with the help of enlarged 3D visual imaging, robotic surgical platforms may execute delicate procedures in confined places, reducing the risk of needless side injuries and enabling more accurate pelvic floor dissection. The postoperative results of infants have been judged satisfactory. Thus, Yanyi Li and colleagues wanted to evaluate the effectiveness of short muscular cuff anastomosis surgery for traditional Hirschsprung disease against laparoscopic-assisted and robot-assisted modified Soave.

This research retrospectively enrolled 60 children with HSCR who received surgical care in our department between January 2021 and December 2023. Operative time, blood loss, anal dissection time, hospital stay duration, postoperative complications, and postoperative defecation control status were among the information gathered.

The anal dissection length and intraoperative blood loss were considerably lower in the robot group than in the laparoscopic group (P < 0.05), although there were no significant changes in the operational time between the two groups (P > 0.05). Furthermore, the duration of hospitalization and the incidence of enterocolitis did not differ significantly between the two groups. When compared to the robot group, a significantly higher number of patients in the laparoscopic group experienced anastomotic problems (P<0.05).

At the follow-up examination, the robot group's feces and soiling frequency were considerably lower than those of the laparoscopic group (P < 0.05). The robot group outperformed the laparoscopic group in terms of postoperative defecation function score (P<0.05). Overall, the robot-assisted modified Soave short muscular cuff anastomosis procedure for classical HSCR has more brief anal dissection time, lower rate of anastomotic complications postoperative fecal function when compared to the laparoscopic-assisted modified Soave short muscular cuff anastomosis procedure.

Reference:

Li, Y., He, S., Jin, Z., Tang, C., Gong, Y., Huang, L., Du, Q., Xia, X., Zhu, D., Zhou, W., Li, Z., Liu, Y., & Zheng, Z. (2025). Comparison of robot-assisted and laparoscopic-assisted modified Soave short muscle cuff anastomosis surgeries for classical Hirschsprung disease. BMC Surgery, 25(1). https://doi.org/10.1186/s12893-025-02799-8