Pediatric robotic surgery: A single-institutional review of the first 100 consecutive cases

Abstract

Robotic surgery is safe and effective in children. An enormous variety of cases can be safely performed including complex cases in neonates and small children. Simple operations such as cholecystectomies have minimal advantages by using robotic technology but can serve as excellent teaching tools for residents and newcomers to this form of minimally invasive surgery (MIS). The technology is ideal for complex hepatobiliary cases and thoracic surgery, particularly solid chest masses.

Robot-assisted Heller’s myotomy for achalasia in children

“…[29] Few robotic myotomies in pediatric patients have been published in the literature (Table 3). [5][6][7][8][9][10][11] The total number of robotic Heller's myotomy cases, including ours, is 18 cases. Most patients underwent a concomitant anti-reflux procedure.…”

“…[2][3][4] Few case reports have been published on robotic-assisted Heller's myotomy in children. [5][6][7][8][9][10][11] The aim of this report is to describe our experience with robotic-assisted Heller's myotomy in children and to review the literature.…”

Paediatric computer-assisted retroperitoneoscopic nephrectomy compared with open surgery

“…By using computer-assisted instruments for all minimally invasive urological procedures, we gain maximum experience with that technique, since port placements and the technique with the instruments differ from standard laparoscopy. This experience is beneficial also in other, more complex procedures, as been pointed out by others [18] such as, in the case of urology, partial nephrectomy and pyeloplasty.…”

“…It offers improved 3-D vision and flexible instruments with a more natural and intuitive range of motion than conventional laparoscopic instruments, and has the potential to facilitate laparoscopic surgery with the same advantages. Some surgeons have managed to perform procedures with these new instruments that they have never done before with the standard laparoscopic instruments [18]. Our team has performed a Morgagni Hernia repair in a small child, and a radical cystoprostatectomy due to a rhabdomyosarcoma in the bladder in a young boy with computer-assisted surgery, thus converting an open procedure to a minimally invasive one with excellent results [19,20].…”

“…The improved manoeuvrability and vision of the da Vinci system compared to standard laparoscopy, is of course most important in reconstructive surgery like pyeloplasties, but is also advantageous in simpler procedures as nephrectomies [8]. The use of the da Vinci® Surgical System, also for simpler cases, shortens the learning curve and increases the probability for succeeding with more complex procedures [18]. prospective, age matched cohorts, the statistical analysis would be more robust and the evidence stronger.…”