Outcomes of robotic-assisted excision of paratubal cysts in a pediatric cohort: A multicentric retrospective study and systematic review

Introduction: Paratubal and paraovarian cysts are benign lesions located between the ovary and fallopian tube, often of mesothelial origin. Although typically asymptomatic, larger cysts may cause pelvic pain or complications requiring surgery. Management depends on cyst size, symptoms, and patient age, with fertility preservation essential in pediatric populations. This multicenter study evaluates robotic-assisted excision of paratubal cysts in children, alongside a literature review. Materials and methods: We performed a retrospective analysis of pediatric patients undergoing robot-assisted paratubal cystectomy at five European pediatric surgery centers. Data included demographics, surgical details, hospitalization, and follow-up. A systematic review following PRISMA guidelines was conducted using Embase, Scopus, PubMed, and Web of Science. Two independent reviewers screened studies and extracted data. Results: Twenty-seven girls underwent robotic cystectomy for cysts measuring 11–176 mm (median 50 mm). Median age was 14 years, with median weight of 56 kg. Median operative time was 88 min. No conversions occurred. Median hospital stay was 2 days (range 1–4), with no complications at median follow-up of 19 months. The review identified 764 records; four studies were included, reporting nine pediatric cases treated robotically without complications. Conclusions: Robotic-assisted surgery appears safe and feasible for paratubal cyst excision in selected pediatric patients, offering precision and minimally invasive access, with favorable perioperative outcomes and preservation of adnexal anatomy. It may support fertility preservation, however evidence regarding long-term reproductive outcomes are lacking and further prospective studies are required.