# Comparing robot-assisted versus laparoscopic Ladd's procedure in children with congenital intestinal malrotation

## TL;DR

This study compares robot-assisted and laparoscopic Ladd's procedures in children with intestinal malrotation, finding that robotic surgery reduces complications but increases costs.

## Contribution

The study provides a novel comparative analysis of robotic versus laparoscopic Ladd's procedures in pediatric patients with congenital intestinal malrotation.

## Key findings

- Robotic cases had no conversions to open procedures, while four laparoscopic cases did.
- Robotic surgery had lower postoperative complication rates compared to laparoscopic surgery.
- Hospitalization costs were significantly higher for robotic procedures.

## Abstract

The aim of this study was to perform a comparative analysis of robot-assisted versus laparoscopic Ladd's procedure on peri- and postoperative outcomes. All Ladd’s procedures performed on patients with congenital intestinal malrotation between January 2020 and December 2023 were identified. Peri- and postoperative data were collected and compared between robot-assisted and laparoscopic groups. Fifty-seven robot-assisted and 38 laparoscopic Ladd’s procedure cases were identified and compared for outcomes. No robotic cases were converted to open procedure, while four laparoscopic cases were converted to open procedure (p = 0.048). Although robotic cases suffered higher hospitalization costs (p < 0.001), the postoperative complication rate was lower for the robotic group compared to the laparoscopic group (p = 0.038). Robot-assisted Ladd's surgery is safe and effective for the treatment of congenital intestinal malrotation in children, reducing the difficulty of surgery, but at increased cost.