Laparoscopy in paediatric urology: adoption of innovative technology

Peters, Craig A.

doi:10.1046/j.1464-410x.92.s1.4.x

Cited by 37 publications

(12 citation statements)

References 34 publications

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“…29 Overall, surgeons agreed that robotic surgery was faster and easier to learn than the laparoscopic equivalent. 35,36,48 The technical complexity of robot placement was described as a disadvantage in robotically assisted PDA procedures. 32 General limitations included the relatively limited selection of instruments, the size of the robotic device, the necessity for dedicated training, significant set-up and docking times, and the lack of haptic feedback.…”

Section: Surgeons' Experiences and Opinionsmentioning

confidence: 99%

Pediatric Robotic Surgery: Early Assessment

Haasteren¹,

Levine²,

Hayes³

2009

Pediatrics

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Section: Surgeons' Experiences and Opinionsmentioning

confidence: 99%

Pediatric Robotic Surgery: Early Assessment

Haasteren¹,

Levine²,

Hayes³

2009

Pediatrics

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“…[22] Robot -assisted laparoscopy has complemented and helped to overcome some of the limitations of conventional laparoscopic techniques, particularly for pediatric reconstructive surgeries. [2324] The da Vinci surgical system, provides the advantage of three-dimensional visualization with tremor-filtered instrument movement and articulating instruments with six degrees of freedom to do delicate manipulation for reconstructive surgery. [25] Applications of this technology have evolved and are now achieving identical results as in open surgery and using suture as small as used in open surgery, 6-0 or 7-0.…”

Section: Robot-assisted Laparoscopymentioning

confidence: 99%

Laparoscopy in the management of pediatric vesicoureteral reflux

2007

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The prevalence of vesicoureteral reflux (VUR) has been estimated as. 4 to 1.8% among the pediatric population. In children with urinary tract infection the prevalence is typically from 30-50% with higher incidence occurring in infancy. When correction of VUR is determined to be necessary, traditionally open ureteral reimplantation by a variety of techniques has been the mainstay of treatment. This approach is justified because surgical correction affords a very high success rate of 99% in experienced hands and a low complication rate. In that context the purpose of this review article is to highlight the use of laparoscopy and robot-assisted techniques to perform ureteric reimplantation for the management of pediatric VUR. A detailed review of recent literature on the subject is performed to find out various aspects of minimally invasive surgery in the treatment of VUR, highlighting evolution of management approaches, operative steps, complications, results and the current status in clinical practice. We also share our experience on the subject.

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“…Therefore, RAS has the potential to overcome many of the impediments of conventional laparoscopic surgery and decrease the learning curve for MIS, especially in pediatric reconstructive procedures. [2,3] RAS also allows the seasoned laparoscopist to become more proficient and refined, expanding the MIS "tool box" to progressively more complex reconstructive procedures (Table 1). [4] The RAS procedure most frequently performed in pediatric urology is pyeloplasty for ureteropelvic junction obstruction (UPJO).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, many other procedures have been performed robotically, such as ureteral reimplantation and nephrectomy, both total and partial. [2,3] More difficult reconstructive procedures such as appendicovesicostomy and bladder augmentation can also be performed in children. Long-term outcome analysis of pediatric urology series have remained largely unexplored as RAS is a recently developed technique yet to be established in the pediatric urological population.…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted laparoscopic surgery in pediatric urology: an update

Kojima¹,

Khurgin²,

Casale³

2012

Turkish Journal of Urology

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Laparoscopic procedures for urological diseases in children, such as nephrectomy, pyeloplasty and orchiopexy, have proven to be safe and effective with outcomes comparable to open procedures. The main drawback has been the relatively steep learning curve for this procedure that is associated with technical difficulties such as suturing and anastomosis. More recently, robotic-assisted laparoscopic surgery (RAS) has gained enormous popularity in adult urology and is increasingly being adopted around the world; however, few pediatric urology series have been reported. RAS has several advantages over conventional laparoscopic surgery, mainly the simplification and precision of exposure and suturing. The robotic arms move in real time with an increased degree of freedom and a magnified, 3-dimensional view. These features render RAS ideal for complex reconstructive surgery in a pediatric urological population. This review discusses the role of RAS in pediatric urology, provides technical aspects of RAS and offers a critical summary of current knowledge on its indications and outcomes. Almost all operations that are classically performed as open or conventional laparoscopic reconstructive surgeries for children with urological anomalies could be replaced by RAS and this procedure may be established as an alternative minimally invasive surgery in the future.Key words: Laparoscopy; minimally invasive surgery; pediatrics; robotics; urinary tract reconstruction; urology. ÖZETÇocuklarda nefrektomi, piyeloplasti ve orşiopeksi gibi ürolojik hastalıklar için laparoskopik prosedürlerin, açık prosedürlerle kıyaslanabilir sonuçlar ile birlikte, güvenli ve etkili olduğu kanıtlanmıştır. Bu prosedür-lerin, sütür atma ve anastamoz gibi teknik zorluklarla ilişkili göreceli dik öğrenme eğrisi olması başlıca dezavantaj olmaktadır. Son zamanlarda, robot yardımlı laparoskopik cerrahi (RAS) erişkin ürolojisinde olağanüstü bir popülerlik kazanmıştır ve bütün dünyada giderek artan bir şekilde kabul görmektedir; buna karşın, bir kaç pediatrik üroloji serisi yayınlanmıştır. RAS konvansiyonel laparoskopik cerrahiye kıyasla bir kaç avantaja sahiptir; bunların başlıcaları pozlama ve sütur atmanın kolaylığı ve hassasiyetidir. Robot kollar artmış bir serbestlik derecesinde ve büyütülmüş 3 boyutlu bir bakış açısıyla gerçek zamanlı olarak hareket etmektedir. Bu özellikler RAS'ı pediatrik ürolojik populasyonda kompleks rekonstrüktif cerrahi için ideal yapmaktadır. Bu derleme pediatrik ürolojide RAS'ın rolünü tartışmakta, RAS'ın teknik yönlerini bildirmekte ve endikasyonları ve sonuçları hakkında güncel bilgilerin eleştirel bir özetini sunmaktadır. Ürolojik anomalisi olan çocuklar için açık veya konvansiyonel laparoskopik rekonstrüktif cerrahi şeklinde klasik olarak yapılan hemen hemen tüm operasyonların yerine RAS yapılabilir ve bu prosedür gelecekte alternatif bir minimal invaziv cerrahi olarak yerleşebilir.

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Laparoscopy in paediatric urology: adoption of innovative technology

Cited by 37 publications

References 34 publications

Pediatric Robotic Surgery: Early Assessment

Pediatric Robotic Surgery: Early Assessment

Laparoscopy in the management of pediatric vesicoureteral reflux

Robotic-assisted laparoscopic surgery in pediatric urology: an update

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