Pediatric Robotic Surgery

Denning, Naomi-Liza; Kallis, Michelle P.; Prince, José M.

doi:10.1016/j.suc.2019.12.004

Cited by 81 publications

(88 citation statements)

References 40 publications

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“…Follow-up was uneventful for all patients (median follow-up 2.1-years [0.2–6.3]). The median length of hospitalization was 2 days ( 1 – 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Installation of the patient requires meticulous attention. Comfortable positioning as well as the use of adequate padding and skin protection must always be verified ( 4 , 40 ). It is important to avoid hyperextension or flexion in small children, as they are more pliable compared with adolescents and adults ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Comfortable positioning as well as the use of adequate padding and skin protection must always be verified ( 4 , 40 ). It is important to avoid hyperextension or flexion in small children, as they are more pliable compared with adolescents and adults ( 4 ). Once the patient is correctly installed, the docking procedure needs to be correctly planned, especially in infants and toddlers, as the working space is limited.…”

Section: Discussionmentioning

confidence: 99%

“…RAS in pediatric surgery has initially struggled due to some limitations, notably port and arm dimensions, as well as high costs ( 3 ). Nevertheless, the growing number of case reports and series published every year reveals how RAS is increasingly applied for children ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Robotics-Assisted Pediatric Oncology Surgery—A Preliminary Single-Center Report and a Systematic Review of Published Studies

et al. 2022

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AimThe use of robotics-assisted surgery in oncology has been proved effective and safe in adults. Despite these results, the use of robotics has been rarely reported for pediatric oncology. Our review aims to evaluate the safety and feasibility of robotics-assisted surgery in this field, analyzing our experience and performing a systematic review of the most recent studies.MethodsWe reviewed all patients affected by an oncological disease who underwent a robotics-assisted procedure at our institute. We performed a systematic review of the literature from 2012 to 2021 on the subjects.FindingsA total of 14 patients underwent robotics-assisted tumor resection. Eleven procedures (median age 13.2-years old) were carried out in children with adnexal lesions (seven tumor excision and four ovariectomies). Histological diagnosis was mature teratoma (six), serous papillary cystadenofibromas of the fallopian tube (two), ovarian serous cystadenoma (one), ovarian mucinous cystadenoma (one), and ovarian seromucinous cystadenoma. The median length of stay was 2 days. No recurrences or complications at a median follow-up of 2.1-years were observed. A 5-year-old girl underwent a complete posterior resection of a type 3 sacrococcygeal tumor with a robotics-assisted approach for the dissection of a possible intraabdominal residual component of the lesion. No intra- and postoperative complications were recorded. Complete excision of a recurrent differentiating neuroblastoma of the left para-renal region was performed on a 9-year-old girl. An idiopathic anaphylactic shock occurred 1 day after the procedure. At 9 months' follow-up, no local recurrences of the lesion were observed. Overall, we reported no conversion to open surgery. Lastly, a robotic excision of a growing left superior mediastinal intermixed ganglioneuroblastoma was performed on an 8-year-old girl with no postoperative complications. Follow-up was uneventful (7 months). In the literature, the rate of complications ranges from 0 to 28%, mainly related to difficult dissection and impaired anatomy. Conversion is reported in 5% of all oncological procedures, due to more invading tumors and altered anatomical features. No robotics-related complications were reported.ConclusionRobotics-assisted surgery in pediatric oncology has proven to be feasible. Nevertheless, its use should be limited to selected cases and performed by highly trained oncological surgeons. Preparation and patient positioning, alongside a correct port placement, are crucial to carrying out these procedures. Further innovations in robotics may allow a wider application of this technology in pediatric oncology.

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“…Follow-up was uneventful for all patients (median follow-up 2.1-years [0.2–6.3]). The median length of hospitalization was 2 days ( 1 – 4 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robotics-Assisted Pediatric Oncology Surgery—A Preliminary Single-Center Report and a Systematic Review of Published Studies

et al. 2022

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“…Image enhanced surgery has been advocated as the future route to safe dissection. Unfortunately, this technology is far from the routine application [33]. Other tools are currently applied in our practice when a robotic approach is indicated.…”

Section: Near-infrared Fluorescence and Robotic-assisted Abdominal Surgerymentioning

confidence: 99%

Innovative Techniques Associated with Traditional Abdominal Surgery in Complex Pediatric Cases: A Tertiary Center Experience

et al. 2021

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Pediatric abdominal surgery is constantly evolving, alongside the advent of new surgical technologies. A combined use of new tools and traditional surgical approaches can be useful in the management of complex cases, allowing less invasive procedures and sometimes even avoiding multiple interventions. This combination of techniques has implications even from the anesthetic point of view, especially in post-operative pain control. Thereby, tertiary level centres, including highly-specialized professionals and advanced equipment, can maximize the effectiveness of treatments to improve the final outcomes. Our paper aims to present some possible combinations of techniques recently used at our institution to provide a one-session, minimally invasive treatment within different areas of abdominal surgery.

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Robotic resection of paediatric solid tumours at a single institution

Liu

et al. 2023

Robotics Computer Surgery

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Background: To explore the clinical application of robotic-assisted surgery in paediatric solid tumours and to explore its feasibility.Methods: From 2015 to 2022, 53 children with solid tumours underwent roboticassisted surgery in our centre were retrospectively analysed. Results:The mean weight of the patients was 27.7 kg, and the mean age was 6.7 years. The average tumour volume was 5.5*4.6*3.7 cm. Two procedures (3.8%) were converted. The mean total operative time was 198.5 min. The mean estimated blood loss was 27.1 ml, and no intraoperative complications occurred. Two (3.8%) patients had postoperative complications. At a median follow-up of 21.2 months, one (1.9%) patient with malignant tumours stopped treatment, and two (3.8%) patients developed tumour recurrence.Conclusions: Robotic-assisted tumour resection is feasible in highly selected cases of young age, light weight, huge tumour or malignant tumour. K E Y W O R D S paediatric, robotic-assisted surgery, solid tumour 1 | INTRODUCTION Minimally invasive surgery (MIS) is globally applied, and it is also widely utilised in children. Robotic-assisted surgery has been used in children in recent years, and many studies have shown its potential advantages of this surgery for patients compared to conventional minimally invasive surgery. Robotic-assisted surgery has also been introduced in the treatment of paediatric solid tumours. 1-3 In 2002, Gutt et al. reported early experiences of robotic-assisted surgery in a child with gonadoblastoma. 4 Cundy et al. published a systematic review of robot-assisted minimally invasive surgery for paediatric solid tumours in 2014. 5 Meignan et al. reported a retrospective analysis of robotic-assisted surgery for paediatric tumours in 2017. 6The current robotic surgery system is designed for adults; moreover, paediatric tumour resection must also abide by oncology principles such as complete tumour resection, the complete removal of tumour specimens and the avoidance of tumour metastasis and dissemination. Some scholars believe that robotic-assisted surgery is risky for children who are young, have a low weight, or have large tumours. In summary, the use of robotic-assisted surgery is limited due to the constraints of tumour surgery principles, age, weight, tumour size, etc. Consequently, the progress of minimally invasive surgery and robotic-assisted surgery for malignant solid tumours in children is proceeding slowly, and there are currently no adequate studies on robotic-assisted surgery in the treatment of paediatric solid tumours.Since the da Vinci robotic surgery system was introduced to our centre in 2015, we have performed robotic-assisted surgery in the treatment of congenital diseases such as choledochal cysts and Hirschsprung's disease, and we performed the first robotic-assisted thoracoscopic mediastinal tumour resection in mainland China in June 2015. As of August 2022, robot-assisted surgery has been completed for 53 paediatric solid tumours in our centre, and the objective of this study was to present our experi...

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Pediatric Robotic Surgery

Cited by 81 publications

References 40 publications

Robotics-Assisted Pediatric Oncology Surgery—A Preliminary Single-Center Report and a Systematic Review of Published Studies

Robotics-Assisted Pediatric Oncology Surgery—A Preliminary Single-Center Report and a Systematic Review of Published Studies

Innovative Techniques Associated with Traditional Abdominal Surgery in Complex Pediatric Cases: A Tertiary Center Experience

Robotic resection of paediatric solid tumours at a single institution

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