Da Vinci Robotic Surgery in a Pediatric Hospital

Mattioli, Girolamo; Prato, Alessio Pini; Razore, Barbara; Leonelli, Lorenzo; Pio, Luca; Avanzini, Stefano; Boscarelli, Alessandro; Barabino, Paola; Disma, Nicola; Zanaboni, Clelia; Garzi, Alfredo; Martigli, Sofia Paola; Buffi, Nicolò Maria; Rosati, U.; Petralia, Paolo

doi:10.1089/lap.2016.0390

Cited by 36 publications

(28 citation statements)

References 40 publications

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“…The general surgical applications have been quite varied in adults, but the technique has been particularly useful in urology for prostate surgery (1–4). There have been few reports that have been published for robotic general pediatric surgery (5–14). Thus, far, the largest number of procedures and publications have been produced for robotic urological pediatric surgery (15–34).…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Arellano

González

2019

Front. Pediatr.

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Objective: We present the applications and experiences of robot-assisted laparoscopic and thoracoscopic surgery (RALTS) in pediatric surgery. Materials and Methods: A prospective, observational, and longitudinal study was conducted from March 2015 to March 2018 that involved a non-random sample of a pediatric population that was treated with RALTS. The parameters examined were: gender, age, weight, height, diagnoses, surgical technique, elapsed time of console surgery, estimated bleeding, need for hemotransfusion, complications, surgical conversions, postoperative hospital stay, and follow-up. The Clavien-Dindo classification of complications was used. The surgical system used was the da Vinci model, Si version (Intuitive Surgical, Inc., Sunnyvale, CA. U.S.A), with measures of central tendency. Results: In a 36-months period, 186 RALTS cases were performed, in 147 pediatric patients and an adult; 53.23% were male, and the remaining were female. The average age was 83 months, ranging from 3.5 to 204 months, plus one adult patient of 63 years. The stature was an average of 116.6 cm, with a range of 55–185 cm; the average weight was 26.9 kg, with a range of 5–102 kg; the smallest patient at 3.5 months was 55 cm in stature and weighed 5.5 kg. We performed 41 different surgical techniques, grouped in 4 areas: urological 91, gastrointestinal and hepatobiliary (GI-HB) 84, thoracic 6, and oncological 5. The console surgery time was 137.2 min on average, ranging from 10 to 780 min. Surgeon 1 performed 154 operations (82.8%), and the remainder were performed by Surgeon 2, with a conversion rate of 3.76%. The most commonly performed surgeries were: pyeloplasty, fundoplication, diaphragmatic plication, and removal of benign tumors, by area. Hemotransfusion was performed for 4.83%, and complications occurred in 2.68%. The average postoperative stay was 2.58 days, and the average follow-up was 23.5 months. The results of the 4 areas were analyzed in detail. Conclusion: RALTS is safe and effective in children. An enormous variety of surgeries can be safely performed, including complex hepatobiliary, and thoracic surgery in small children. There are few published prospective series describing RALTS in the pediatric population, and most only describe urological surgery. It is important to offer children the advantages and safety of minimal invasion with robotic assistance; however, this procedure has only been slowly accepted and utilized for children. It is possible to implement a robust program of pediatric robotic surgery where multiple procedures are performed.

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Section: Introductionmentioning

confidence: 99%

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Arellano

González

2019

Front. Pediatr.

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“…Unilateral [15][16][17][18][19] with encouraging results. The first applications of RAL for pediatric renal tumors were reported by Cost et al, who described in 2012 transperitoneal partial nephrectomy 20 and in 2014 a nephrectomy in an adolescent with WT.…”

Section: Indications Contraindicationsmentioning

confidence: 97%

“…The lack of haptic feedback may be considered as a potential limitation, especially in tumors that cannot be fragmented such as WT. A few case series had been reported since the first article of Meehan et al in 2013 with encouraging results. The first applications of RAL for pediatric renal tumors were reported by Cost et al, who described in 2012 transperitoneal partial nephrectomy and in 2014 a nephrectomy in an adolescent with WT .…”

Section: Introductionmentioning

confidence: 98%

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Blanc

Pio

Clermidi

et al. 2019

Pediatric Blood & Cancer

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Aim We present the preliminary results of robotic‐assisted laparoscopic (RAL) total and partial nephrectomy for renal malignant tumors in children. Methods This is a prospective study of patients operated with RAL between December 2016 and September 2018. Patients with Wilms tumors were treated according to the SIOP‐2001 protocol. Patient and tumor characteristics, type of surgery, surgical‐related morbidity, and oncologic outcomes were recorded. Results were compared with a series of patients with similar age‐ and tumor‐related characteristics operated during the same period by an open surgical approach. Results Ten children underwent RAL nephrectomy with a mean age of five years (3.2–14.1 years). Total nephrectomy was done in six cases for Wilms tumor and in one case for renal sarcoma; three cases were converted. Complete removal of tumor without rupture was achieved in all cases. Postoperative course was uneventful, and patients were discharged between days 2 and 7. Neither recurrence nor medium‐term complications occurred. Nine patients are alive with a median follow‐up of 16 months (6–27 months) and one female died from complications of central nervous system metastases one year after surgery. When compared with the open surgical approach group, median tumor volume was smaller (P = 0.005), hospital stay was shorter (P = 0.01), and operative time was similar (P = 0.20). Conclusions RAL total and partial nephrectomy procedure for renal tumor in children may be an option in carefully selected cases. Indication should be discussed at tumor boards and surgery performed while adhering strictly to oncological surgical rules.

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“…There have been few reports that have been published for robotic general pediatric surgery [44][45][46][47][48][49][50][51][52][53]. Numerous case reports, case series, and comparative studies have unequivocally demonstrated that robotic surgery in children is safe [54].…”

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Laparoscopic Redo Nissen Fundoplication. Does it Offer Advantages in Children?

Arellano¹

2019

AJPN

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Da Vinci Robotic Surgery in a Pediatric Hospital

Cited by 36 publications

References 40 publications

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Robotic‐assisted laparoscopic management of renal tumors in children: Preliminary results

Robotic-Assisted Laparoscopic Redo Nissen Fundoplication. Does it Offer Advantages in Children?

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