Severance Hospital said on the 1st that it successfully performed a robot-assisted Kasai surgery on a newborn with biliary atresia who was 14 days old and weighed 3.14 kg.
The hospital said this is the world's youngest and lowest-weight Kasai surgery case not reported in the literature.
Biliary atresia is a rare, intractable disease in which bile does not drain into the small intestine and accumulates in the liver, occurring in about 1 in 10,000 newborns. If treatment is delayed, it can progress to cirrhosis and liver failure, so early diagnosis and surgery are critical.
The Kasai surgery is the standard treatment that removes the blocked bile ducts and directly connects the hepatic hilum to the small intestine to allow bile to flow.
In Kyung, a pediatric surgery professor at Severance Hospital, performed the robot-assisted Kasai surgery over about five hours on A, a 14-day-old girl born with biliary atresia, on the 4th of this month. The operation involved almost no bleeding and was completed without a transfusion, and A recovered without notable complications and was discharged on the 30th of last month.
The medical team devised a treatment plan through multidisciplinary collaboration starting at the prenatal diagnosis stage.
During pregnancy, a cystic lesion under the liver was found on a prenatal ultrasound, and A received detailed care at the high-risk maternal-fetal integrated treatment center at Severance Hospital. Obstetrics and gynecology, neonatology, and pediatric surgery teams began collaboration before delivery, and a detailed examination immediately after birth indicated a high likelihood of biliary atresia, leading to an early decision for surgery.
In particular, for newborns weighing in the 3-kg range, the abdominal cavity is very narrow, making the dissection and anastomosis of organs difficult and requiring highly advanced techniques. The hospital performed the surgery through multidisciplinary collaboration involving pediatric surgery, neonatology, obstetrics and gynecology, anesthesiology and pain medicine, the surgical nursing team, and the robot endoscopic surgery center.
In Kyung, a pediatric surgery professor at Severance Hospital, said, "For this infant, care was organically connected from prenatal diagnosis to evaluation right after birth, neonatal intensive care, and pediatric surgery, allowing treatment at a very early stage."
The professor added, "Performing robot-assisted Kasai surgery on a newborn in the 3-kg range is a very demanding challenge in terms of operating space and instrument handling, but based on the precision of robotic surgery and multidisciplinary collaboration, we were able to complete the operation safely."