A Comprehensive Analysis of Robot-Assisted Surgery Uptake in the Pediatric Surgical Discipline

Abstract

Introduction: Robotic assisted surgery (RAS) is one of the most recent surgical approaches that has quickly been adopted by the pediatric urology community. Over the last decade, a vast amount of manuscripts has been published, supporting the safety and applicability of RAS in the pediatric population. The quality of published literature about this innovative technology remains supported by case-reports and retrospective case-series. Historical behavior of literature productivity and implementation of laparoscopy followed a similar trend. We present the historical publication uptake of RAS in pediatric urology and other surgical disciplines using a bibliometric comparison of the most cited manuscripts.Materials and Methods: A systematic search and review of the literature was undertaken by the authors. Literature search was performed in OVID, PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. The search period included all publications between 1985 and June 2018. All languages were included. Data analysis for graphical representation was performed using VOSviewer® version 1.6.8 and Impact Index Analysis was used to adjust the citations by the time since publication.Results: A total of 1,014 titles were identified. After applying exclusion criteria, 200 papers were included for the RAS arm and 402 for the laparoscopic one. Case-series was the most common type of publication. Average citations for laparoscopic manuscripts was 23 (SD ± 31) and for RAS was 20 (SD ± 31.5). The impact index analysis showed an average of 95 (SD ± 167) for laparoscopic manuscripts vs. 66 (SD ± 101) for RAS. The laparoscopic manuscript with the highest citation count had 199 citations with an impact index of 12.1. And the RAS manuscript with the highest citation count had 280 citations and an impact index of 4.3.Conclusion: Literature productivity in pediatric laparoscopic and RAS has quickly grown. Pediatric Urologists play a key role in the introduction of this innovative tool. Literature supporting its implementation and future consolidation requires to focus on increasing the level of evidence.

Robotic-Assisted Surgery in Pediatrics: What Is Evidence-Based? A Review of the Literature

“…To date, the most common procedures described using the da Vinci Surgical System are pyeloplasty and ureteral reimplantation, followed by fundoplication of the stomach [5,32]. Interestingly, a review of the literature and a meta-analysis reporting outcomes of children undergoing mini-invasive fundoplication found no signi cant difference in terms of operating time, length of hospital stay, and postoperative complications.…”

“…The use of robotic-assisted surgery (RAS) has increased more slowly in pediatrics than in the adult population [5,6]. Despite the many advantages of robotic instruments, such as the ability to mimic the movements of the human wrist, highly magni ed 3D visualization, and tremor ltration, the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) still presents some limitations for use in pediatric surgery.…”

Robotic-Assisted Minimally Invasive Surgery in Children

“…Fundoplication is the most widely performed and reported robotic-assisted surgery in pediatric general and thoracic surgery [3].…”

“…As is often the case for new devices, technology, and therapeutic options in surgery, the application of robotic surgery for children has occurred more slowly than in adults. This caution is due in part to technical limitations with developing appropriately sized instruments for the pediatric patient; however, in recent years broader implementation has been seen [3][4][5][6].…”

Brief chronological progress in the management of intussusception: 1674 to 2021

“…54 Robotic Surgery (Robotic-Assisted Surgery) is one of the most recent surgical techniques employed across all age groups. 55,56 On April 11, 1985, a world-first roboticassisted brain biopsy in an adult was -performed at Long Beach Memorial Medical Center, California. 55 The first robotic-assisted surgical procedure in a child was undertaken in March 2002 by Peter et al 56 Roboticassisted reduction/bowel resection for intussusception has not been performed probably, to date.…”