Robotics and future technical developments in pediatric urology

Esposito, Ciro; Autorino, Giuseppe; Castagnetti, Marco; Cerulo, Mariapina; Coppola, Vincenzo; Cardone, Roberto; Esposito, Giulia; Borgogni, Rachele; Escolino, Maria

doi:10.1016/j.sempedsurg.2021.151082

Cited by 25 publications

(18 citation statements)

References 32 publications

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“…Conversely, an analysis of the literature shows that the main indication of RAS in pediatrics is represented by pediatric urology indications. Specifically, the main indications for RAS in pediatric urology are: (I) pyeloplasty for ureteropelvic junction obstruction, and (II) ureteral reimplantation according to the Lich-Gregoire technique, principally in case of bilateral reflux or high degree reflux with megaureter ( 15 , 16 , 43 , 44 ). Notably, even though several studies have documented advantageous outcomes in older children, the application of RAS in infants with urological diseases weighing less than 10 kg is still being investigated and a cut-off weight has yet to be determined ( 6 , 45 ).…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted surgery in pediatrics: what is evidence-based?—a literature review

Boscarelli¹,

Giglione²,

Caputo³

et al. 2023

Transl Pediatr

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Background and Objective: The use of robotic-assisted surgery (RAS) has increased more slowly in pediatrics than in the adult population. Despite the many advantages of robotic instruments, the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) still presents some limitations for use in pediatric surgery. This study aims to examine evidence-based indications for RAS in the different fields of pediatric surgery according to the published literature.Methods: A database search (MEDLINE, Scopus, Web of Science) was performed to identify articles covering any aspect of RAS in the pediatric population.

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Section: Discussionmentioning

confidence: 99%

Robotic-assisted surgery in pediatrics: what is evidence-based?—a literature review

Boscarelli¹,

Giglione²,

Caputo³

et al. 2023

Transl Pediatr

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“…Currently, pneumatic, laser and, to a lesser extent, electrohydraulic lithotripters are used to fragment stones in children [16]. Recent advances in robotic surgery will open the doors for even less invasive robotic-assisted removal of bladder stones in pediatric patients [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, robot-assisted laparoscopic surgery has demonstrated efficacy in the treatment of large-volume stones, especially in conditions requiring simultaneous reconstruction [12]. However, robotic surgery in pediatric bladder stones or urolithiasis still needs more evidence to be implemented within the practice [13,14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Safety and Efficacy of Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment of Bladder Stones in Children

Ziad

Muter

2022

JCM

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This study aimed to compare the safety and efficacy of laser lithotripsy and pneumatic lithotripsy, the two most commonly used transurethral lithotripsy methods for treating bladder stones in children in Iraq. Between January 2013 and December 2016, 64 children with bladder stones were included in this prospective randomized study, after ethical committee approval and written consent from the children’s parents or caregivers were obtained. Patients were assigned randomly by computer software to two groups treated with either pneumatic cystolithotripsy or laser lithotripsy. A 9 Fr. semirigid ureteroscope was used to pass the lithotripter through and fragment the stone. A catheter of 8–12 Fr. was then introduced and kept in place for 24 h. All children were hospitalized for 24 h, and the catheter was removed the next morning. Outpatient follow-up was maintained for 6–12 months. In terms of operation outcomes and complications, the laser lithotripsy group had a significantly longer duration of operation (74.5 ± 26.6 min vs. 51.5 ± 17.2 min, p = 0.001), whereas the number of patients requiring an extended hospital stay was significantly higher in the pneumatic lithotripsy group (48.5% vs. 16.1%, p = 0.006). Moreover, pneumatic lithotripsy was associated with a significantly greater risk of having at least one adverse effect (64% greater than that in the laser group). Stone clearance rates did not significantly differ between treatment groups. In conclusion, both pneumatic and laser lithotripters can be used to treat children with bladder stones with high efficacy and safety.

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“…Conversely, an analysis of the literature shows that the main indication of RAS in pediatrics is represented by pediatric urology indications. Speci cally, the main indications for RAS in pediatric urology are: 1) pyeloplasty for ureteropelvic junction obstruction, and 2) ureteral reimplantation according to the Lich-Gregoire technique, principally in case of bilateral re ux or high degree re ux with megaureter [35,[40][41][42]. Notably, even though several studies have documented advantageous outcomes in older children, the application of RAS in infants with urological diseases weighing less than 10 kg is still being investigated and a cutoff weight has yet to be determined [6,43,44].…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Surgery in Pediatrics: What Is Evidence-Based? A Review of the Literature

Boscarelli

Giglione

Caputo

et al. 2022

Preprint

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Aim of the study: This study examines evidence-based indications for robotic-assisted surgery (RAS) in the different fields of pediatric surgery.Methods: A systematic database search (MEDLINE, Scopus, Web of Science) was performed to identify articles covering any aspect of RAS in the pediatric population. Using Boolean operators AND/OR, all possible combinations of the following search terms were used: robotic surgery, pediatrics, neonatal surgery, thoracic surgery, abdominal surgery, urologic surgery, hepatobiliary surgery, and surgical oncology. The selection criteria were limited to the English language, pediatric patients (under 18 years of age), and articles published after 2010.Main Results: A total of 239 abstracts were reviewed. Of these, 10 published articles met the purposes of our study with a level of evidence I/II and therefore were analyzed. Notably, most of the articles included in this review reported evidence-based indications in urological surgery.Conclusions: According to this study, the exclusive indications for RAS in the pediatric population are pyeloplasty for ureteropelvic junction obstruction in older children and ureteral reimplantation according to the Lich-Gregoire technique in selected cases for the need to access the pelvis with a narrow anatomical and working space. All other indications for RAS in pediatric surgery are still under discussion to date, and cannot be supported by papers with a high level of evidence. However, RAS is certainly a promising technology. Further evidence is strongly encouraged in the future.

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Robotics and future technical developments in pediatric urology

Cited by 25 publications

References 32 publications

Robotic-assisted surgery in pediatrics: what is evidence-based?—a literature review

Robotic-assisted surgery in pediatrics: what is evidence-based?—a literature review

Comparison of the Safety and Efficacy of Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment of Bladder Stones in Children

Robotic-Assisted Surgery in Pediatrics: What Is Evidence-Based? A Review of the Literature

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