Robotic partial nephrectomy in the pediatric population: Cumulative experience at a large pediatric hospital

Antar, Ali; Agard, Hannah; Bates, Jenna N.; Kim, Soo Jeong; Saleem, Asad A; Bhatia, Vinaya; Link, Richard E.; Koh, Chester J.

doi:10.1016/j.jpurol.2022.06.029

Cited by 4 publications

(1 citation statement)

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“…Indications for robotic partial nephrectomy, radical nephrectomy, and nephroureterectomy in the pediatric population remain similar to those in adults, such as kidney tumors, anatomical anomalies, and nonfunctioning kidneys. Recently, a series of pediatric patients were studied after robotic nephrectomies (35). About one-third of these were partial nephrectomies, Anesth Pain Med.…”

Section: Robotic Partial Nephrectomy Radical Nephrectomy and Nephrour...mentioning

confidence: 99%

Robotic Pediatric Urologic Surgery-Clinical Anesthetic Considerations: A Comprehensive Review

Khater,

Swinney,

Fitz-Gerald

et al. 2024

Anesth Pain Med

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: Minimally invasive robotic approaches have become standard in many institutions over the last decade for various pediatric urological procedures. The anesthetic considerations for common laparoscopic and robotic-assisted surgeries are similar since both require the insufflation of CO2 to adequately visualize the operative area. However, few studies exist regarding anesthesia for robotic procedures in children. We hypothesized that pediatric patients undergoing robotic urologic surgeries would require specific anesthetic strategies, especially given the inherently longer durations of these procedures. This study aimed to evaluate anesthetic considerations, current robotic procedures, optimal patient positioning, and port placement for robotic-assisted surgery in pediatric patients. A comprehensive literature review of all published manuscripts from PubMed, EMBASE database, and Google Scholar was performed, focusing on robotic procedures involving pediatric patients, anesthesia for pediatric urology patients, and related topics from 1996 to 2023. Forty published manuscripts were identified and reviewed in depth. In pediatric cases, insufflation pressures and volumes are lower due to the laxity of the abdominal wall. However, the increase in intra-abdominal pressure and absorption of CO2 may result in disproportionate changes in cardiopulmonary function. Specific patient positioning for robotic approaches may further compound these physiological changes. Correct patient positioning is essential to facilitate surgery optimally and safely. Understanding the physiological changes that can occur during a pediatric patient’s robotic urologic surgery allows for safer anesthesia management.

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Section: Robotic Partial Nephrectomy Radical Nephrectomy and Nephrour...mentioning

confidence: 99%