Rise of pediatric robotic surgery in Italy: a multicenter observational retrospective study

Abstract

Background The minimally invasive surgery (MIS) in term of robot-assisted surgery changed in a dramatic way the surgical approach either in adults or children. For many specialties (urology, gynecology, general surgery) robotic surgery rapidly became the gold standard for some procedures, while the experience in pediatric population is not wide for some reasons. The aim of this study is to retrospective analyze trends of application of robotic surgery in pediatric patients across the country, focusing on indications, limitations, development, and training acquired by national experience and in comparison to the literature. Methods We made a retrospective multicenter study on behalf of Italian Society of Pediatric Surgery. We performed a census among all pediatric surgery units in the country to enroll those performing robotic surgery on children between 2013 and 2019. Results We enrolled 7 pediatric surgery referral Centers (Ancona, Bologna, Brescia, Genova, Pavia, Pescara, Siena). A total of 303 patients were included in the study, 164 males (54%) and 139 females (46%). The most commonly performed interventions for each anatomic area were respectively atypical pulmonary resection (38%), pyeloplasty (49%), and fundoplication (30%). Conclusions Since its first application in Italy, about 10 years ago, several considerations were made about application and feasibility of robotics in children.

Robotic resection of paediatric solid tumours at a single institution

“…Angotti et al. pointed out that paediatric robotic surgery is a field in development which presents a progressive growth 9 . This technology has been used for nearly 20 years, but there are still few relevant research reports about paediatric tumours 5,8 .…”

“…7,8 Angotti et al pointed out that paediatric robotic surgery is a field in development which presents a progressive growth. 9 This technology has been used for nearly 20 years, but there are still few relevant research reports about paediatric tumours. 5,8 The reasons for the limited application of robotic-assisted surgery include the relatively low incidence rate of paediatric solid tumours, the high cost, and the current robotic-assisted surgery system is developed for adults, whether it can be used in younger children, especially infants and newborns, remains controversial.…”