Narrative review: robotic pediatric surgery—current status and future perspectives

Abstract

Background and Objective Robot-assisted surgery has been progressively involved in various fields of adult and pediatric surgery, demonstrating many advantages over either mini-invasive or open surgery. The aim of this review is to provide the most recent evidence on robot-assisted pediatric surgery, in all its subspecialties. Methods A comprehensive electronic literature search of PubMed, Embase, and Cochrane Library was conducted using appropriate Medical Subject Headings (MeSH) terms and keywords. The interval time considered was a 5-year period [2017–2022], and no language restrictions were applied. Key Content and Findings A total of 685 titles were identified. After applying exclusion criteria, 73 articles for robotic pediatric surgery have been published and were included in this review. We extrapolated and summarized the current evidence on robot-assisted surgery in pediatric age through all the fields of applicability. Conclusions Robot-assisted surgery is technically feasible in case of a selected pediatric cohort, and it is going to achieve similar or better surgical results if related to the standard open or mini-invasive procedures. Copious case series and randomized trials are still required. Due to the great potential that this new technology is demonstrating, in the close future, the evolution of robotic platform will offer a valid and solid alternative in the treatment of various pediatric pathologies.

Indocyanine green (ICG) fluorescence technology in pediatric robotic surgery

“…In the last decade, two significant innovations have emerged in pediatric surgery and urology: the adoption of robotic surgery to address pediatric surgical conditions and the utilization of FGS with ICG [ 5 , 6 , 14 , 15 ]. Our teams were among the pioneers in both techniques, having initiated the use of robotics approximately 19 years ago [ 16 ] and incorporating ICG technology into our practice over the last 7 years [ 17 , 18 ].…”

Small Scale, High Precision: Robotic Surgery in Neonatal and Pediatric Patients—A Narrative Review

“…Numerous studies indicate that robotic-assisted surgery in pediatric settings has shown particular efficacy in certain pathologies, leveraging its precision, enhanced visualization, and minimally invasive nature [ 46 , 47 ]. One notable area where robotic assistance has demonstrated significant advantages is in congenital heart surgeries, especially in intricate procedures involving repairs of congenital cardiac anomalies [ 48 ].…”

“…AI algorithms can aid surgeons in real-time decision making, procedural planning, and even automation of certain tasks, reducing the cognitive load on surgeons and potentially improving overall efficiency. The integration of AI-driven technologies holds promise for further refining surgical techniques and expanding the scope of robotic-assisted interventions in pediatrics [ 47 , 61 ].…”

“…Improved haptic feedback can provide a more realistic sense of touch, enabling surgeons to better navigate delicate tissues and perform intricate maneuvers with heightened precision. These developments contribute to the ongoing efforts to bridge the gap between traditional open surgeries and minimally invasive robotic procedures in pediatric patients [ 47 , 61 ].…”