Individualized robotic organ‐sparing surgery in a paediatric case of renal perivascular epithelioid cell tumour

Silveri, Massimiliano; Natali, Gian Luigi; Cobellis, Giovanni; Roberti, Agnese; Rossi, Sabrina; Gregori, Lorenzo; Torino, Giovanni

doi:10.1002/rcs.2142

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In past years, there was no evidence that the robot was the suggested approach for these types of surgeries, due to the fact that neither gastric duplication excision nor a heminephrectomy had a reconstructive part. In these cases, although it does not present a significant advantage, the use of robotic surgery has proven to be a novel and effective way in the minimally invasive performance of these surgical procedures [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic Surgery: Is There a Possibility of Increasing Its Application in Pediatric Settings? A Single-Center Experience

Bindi¹,

Todesco²,

Nino³

et al. 2022

Children

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Introduction: Robotic surgery has shown explicit benefits and advantages in adults, but it is not yet strongly established in the pediatric population, even though its popularity is increasing, especially in the urologic field. Materials and methods: In this article we present our experience with the Da Vinci System (SI first and XI nowadays) at our pediatric institution in order to analyze our progress over the years. We considered all patients from the start of the robotic surgery program in 2016 until the end of 2021, dividing them into general abdominal surgery and genitourinary surgery. Analyzed data were the patient’s demographic, details of surgery, and intra and post-operative complications. Results: The total number of patients (pts) included in this study was 76, of whom 40 (52%) were male and 36 (48%) were female. The mean age at surgery was 90.9 months (range 10–207 months), and the mean weight at surgery was 29.3 kg (range 9.5–68 kg). There were 18 general abdominal robotic surgeries and 58 genitourinary robotic surgeries performed. The most performed surgeries in these two categories were fundoplication for gastro-oesophageal reflux disease (11%) and Anderson–Hynes pyeloureteroplasty. The mean operative time was 224.2 min (range 72–530 min): the mean times in the two groups (general abdominal surgery and genitourinary surgery) were 165 min (range 84–204 min) and 194 min (range 95–360 min), respectively. A total of four (5%) minor complications were reported. The total conversions were two (2.6%) and the mortality rate was 0%. Conclusions: Pediatric robotic surgery is a field of considerable interest and it is rapidly expanding. In our experience, it is evident how the learning curve has increased gradually, but steadily, allowing us to advance from standardized surgery, such as fundoplication and pieloplasty, towards a more technically complex one, achieving the same good results. We believe that robotic surgery is very respectful of tissues and feasible, especially for reconstructive surgery. For these reasons, it could become of common use also in the pediatric population, overcoming impediments such as excessive cost and the lack of pediatric instruments, in order to be able to treat children with a progressively lower age and weight.

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Section: Discussionmentioning

confidence: 99%

Robotic Surgery: Is There a Possibility of Increasing Its Application in Pediatric Settings? A Single-Center Experience

Bindi¹,

Todesco²,

Nino³

et al. 2022

Children

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“…[12][13][14] Experience in children and adolescents is still limited and based on case reports and two small case series for a total of fewer than 20 patients. [15][16][17][18][19][20] Overall, RAL was employed for radical nephrectomy in eight 19,20 and for NSS in 11 patients. [15][16][17][18][19][20] All reported RAL partial nephrectomies were performed with clamping of the renal vessels and a warm ischemia time ranging from 14 to 40 minutes.…”

Section: Current Approaches/controversiesmentioning

confidence: 99%

“…[15][16][17][18][19][20] Overall, RAL was employed for radical nephrectomy in eight 19,20 and for NSS in 11 patients. [15][16][17][18][19][20] All reported RAL partial nephrectomies were performed with clamping of the renal vessels and a warm ischemia time ranging from 14 to 40 minutes.…”

Section: Current Approaches/controversiesmentioning

confidence: 99%

“…Robotic‐assisted laparoscopic (RAL) surgery numbers have gained popularity in adult kidney surgery in the last two decades; specifically, it has become the standard approach for NSS in patients with renal cell carcinoma (RCC) in many centers 12–14 . Experience in children and adolescents is still limited and based on case reports and two small case series for a total of fewer than 20 patients 15–20 …”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

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Technical advances in the surgical management of Wilms tumors in children

Romao

Steeg

Malek

et al. 2023

Pediatric Blood & Cancer

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Surgery is one of the cornerstones of Wilms tumor treatment. In this article, we present technical advancements that are finding their way into the armamentarium of pediatric cancer surgeons. We discuss the current approaches, challenges, opportunities, and future directions of minimally invasive surgery (laparoscopic and robotics), image‐guided surgery, and fluorescence‐guided surgery. Furthermore, we discuss the use of intraoperative ultrasonography, as well as the use of new techniques to improve the quality of lymph node sampling.

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Status of robotic surgery in pediatric genitourinary tumors: A systematic review

Yadav,

Alshammari,

Ahmad

et al. 2024

Int J of Urology

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Innovative surgical approaches are crucial in pediatric oncology to enhance treatment outcomes and minimize morbidity. Robotic‐assisted surgery (RAS) has shown promise in both surgical precision and recovery in pediatric patients. This systematic review aims to address this gap by examining the current role and impact of RAS in managing pediatric genitourinary tumors, focusing on its feasibility, safety, and patient outcomes. This review was registered with PROSPERO (CRD42023464820). We included studies involving pediatric patients undergoing RAS for genitourinary tumors, focusing on outcomes like conversion rates, resection completeness, and complications. Studies were identified through searches in PubMed, EMBASE, and Scopus until October 2023. Study quality and bias were assessed using ROBINS‐I for cohort studies and Joanna Briggs Institute tools for case reports and series. Of 2119 citations, 42 studies were included, comprising 29 case reports, five case series, and eight retrospective cohort studies. Robotic‐assisted renal surgeries were most common, with favorable outcomes in terms of resection completeness and low recurrence rates. Adrenal, bladder, and retroperitoneal surgeries also showed promising results, although rare instances required conversion to open surgery. Collaborative efforts and perioperative aids like intraoperative ultrasound and three‐dimensional modeling were crucial for success. This work is limited by the lack of large cohort studies and addressing the learning curve associated with these procedures. RAS shows promise in treating pediatric genitourinary tumors, offering precise resections and favorable outcomes, warranting further research and refinement.

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Individualized robotic organ‐sparing surgery in a paediatric case of renal perivascular epithelioid cell tumour

Cited by 3 publications

References 9 publications

Robotic Surgery: Is There a Possibility of Increasing Its Application in Pediatric Settings? A Single-Center Experience

Robotic Surgery: Is There a Possibility of Increasing Its Application in Pediatric Settings? A Single-Center Experience

Technical advances in the surgical management of Wilms tumors in children

Status of robotic surgery in pediatric genitourinary tumors: A systematic review

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