Pediatric Challenges in Robot-Assisted Kidney Transplantation

Grammens, Julien; Schechter, Michal Yaela; Desender, Liesbeth; Claeys, Tom; Sinatti, Céline; Vandewalle, Johan; Vermassen, Frank; Raes, Ann; Vanpeteghem, Caroline; Prytuła, Agnieszka; Sılay, Mesrur Selçuk; Breda, Alberto; Decaestecker, Karel; Spinoit, Anne‐Françoise

doi:10.3389/fsurg.2021.649418

Cited by 13 publications

(4 citation statements)

References 41 publications

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“…The future focus should be placed on further development of the robotic surgery instruments needed for pediatric patients of all ages, wider availability, and clear cost-effectiveness (46) as a reliable option for complex procedures that are currently difficult to approach laparoscopically (47) .…”

Section: Discussionmentioning

confidence: 99%

Implementing a pediatric robotic surgery program: future perspectives

Beauregard¹,

García²,

Amillo³

et al. 2022

Cir Pediatr

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The minimally invasive approach using robotic technology is fully incorporated in the treatment of adult pathologies.The first international pediatric studies with a robotic approach date from 2002, and in Spain, from 2009. We present the implementation of a Pediatric Robotic Surgery program in our setting. Materials and methods.A proposal for the application of robotic technology in pediatrics was developed, and after the acquisition of a Da Vinci Xi system at our center, a program was initiated under the guidance of a pediatric surgeon experienced in this approach.Results. 32 patients with a median age of 12 years (7 months-17 years) have been operated on since January 2019. 56% of the procedures were abdominal. 3 thoracic approaches and 11 urologic procedures were carried out. 1 conversion to open surgery was performed during a fundoplication. The median combined duration of abdominal and thoracic approaches was 155 minutes (70-380 minutes). There were no anesthetic or hemodynamic complications. The postoperative period in the cases in which the procedure was completed was uneventful, and patients were discharged after a median of 2 days (1-16 days). Conclusion.The main advantage of robotic procedures is the symmetrical movement in line with the surgeon's hands, which makes the learning curve shorter. In our experience, the robotic approach has allowed for greater precision in the surgical technique, favoring the patient's recovery.

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Section: Discussionmentioning

confidence: 99%

Implementing a pediatric robotic surgery program: future perspectives

Beauregard¹,

García²,

Amillo³

et al. 2022

Cir Pediatr

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“…En nuestra experiencia el abordaje robótico permite una mayor precisión en aquellos procedimientos que requieren disección meticulosa y que precisan de sutura. El objetivo futuro debe centrarse en potenciar el desarrollo de la instrumentación robótica necesaria para el paciente pediátrico de todas las edades, la disponibilidad más amplia y una rentabilidad clara (46) al ser una opción fiable en los procedimientos complejos que actualmente presentan dificultades en su abordaje laparoscópico (47) .…”

Section: Materials Fungible Da Vinci Cirugía De Disección: Tumor Abdo...unclassified

Implementación de un programa de cirugía robótica pediátrica. Perspectivas futuras

Beauregard¹,

García²,

Amillo³

et al. 2022

Cir Pediatr

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ResumenIntroducción. El abordaje mínimamente invasivo empleando tecnología robótica está plenamente incorporado a la patología del adulto.Las primeras series pediátricas internacionales con abordaje robótico datan del año 2002 y en España del 2009. Presentamos la implementación de un programa de Cirugía Robótica Pediátrica en nuestro centro.Material y método. Se elaboró una propuesta de aplicación de la tecnología robótica en el área pediátrica y tras la adquisición de una plataforma Da Vinci Xi en nuestro centro, se procedió al inicio del programa bajo la tutorización de un cirujano pediátrico experimentado en este abordaje.Resultados. Se han intervenido 32 pacientes con una mediana de edad de 12 años (7 meses-17 años) desde enero de 2019. El 56% de los procedimientos fueron abdominales. Se realizaron tres abordajes torácicos y 11 procedimientos urológicos. Se realizó una conversión a cirugía abierta durante una fundoplicatura. La mediana de la duración en conjunto de los abordajes abdominales y torácicos fue de 155 minutos (70-380 minutos). No hubo complicaciones anestésicas ni hemodinámicas. El postoperatorio en los casos en los que se concluyó el procedimiento no presentó incidencias y el alta se realizó con una mediana de 2 días (1-16 días).Conclusión. La principal ventaja de los procedimientos robóticos es el movimiento simétrico en línea con las manos del cirujano, lo que hace que la curva de aprendizaje sea más corta. En nuestra experiencia, el abordaje robótico nos ha permitido una mayor precisión en la técnica quirúrgica favoreciendo la recuperación del paciente.

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“…robotic and computer technologies [5]- [6]. Therefore, the capabilities of surgeons are enhanced with high precision and accuracy for the complex procedure in the constrained workspace [7]. The robot-assisted surgical system has several advantages, but it also has some disadvantages.…”

Section: Introductionmentioning

confidence: 99%

“…The studies above are primarily concerned with adult endoscopic surgery; however, applying their findings to pediatric endoscopic surgery is challenging. It has been reported previously that endoscopic surgery for pediatric patients is significantly more complex than conventional endoscopic surgery for adults [6]- [7], [35]. The narrow workspace in the PMAS, which is significantly smaller than that of an adult patient, is the primary cause of its difficulties.…”

Section: Introductionmentioning

confidence: 99%

Active Constrained Motion Control for a Robot-Assisted Endoscope Manipulator in Pediatric Minimal Access Surgery

2024

Preprint

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Robot-assisted laparoscopic surgery has three main system requirements: safety, simplicity, and intuitiveness. However, accidental movement of the endoscope due to body fatigue and misunderstanding of the verbal orders between the surgeon and assistant will contribute to highly unexpected tool-tissue interactions, particularly in pediatric minimal-access surgery with restricted working space. This study introduces a compact, lightweight endoscope manipulator with a mechanical remote-center-motion function. Using a custom-designed human-machine interface, the surgeon can intuitively control the movement of the endoscope manipulator over their view. In addition, an active constrained motion control algorithm is proposed to generate a forbidden-region constraint for avoiding collisions between the endoscope tip and surrounding organs in a pediatric abdominal cavity with restricted space. Simulations and experiments demonstrate the performance of the proposed compact endoscope manipulator and the active constrained surface tracking control scheme.

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Pediatric Challenges in Robot-Assisted Kidney Transplantation

Cited by 13 publications

References 41 publications

Implementing a pediatric robotic surgery program: future perspectives

Implementing a pediatric robotic surgery program: future perspectives

Implementación de un programa de cirugía robótica pediátrica. Perspectivas futuras

Active Constrained Motion Control for a Robot-Assisted Endoscope Manipulator in Pediatric Minimal Access Surgery

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