Anesthesia experience of pediatric robotic surgery in a University Hospital

Abstract

Robotic technology has a promising future in surgical field. Robotic-assisted laparoscopy is a newly advance technology which is highly accepted by most of surgeons in various surgical procedures. As the pediatric surgeons adopt and master robotic technique, anesthesiologists familiarized themselves with this technique as well. Robotic surgery required a high-quality of perioperative anesthesia care that is essential for optimizing surgical outcome and patient safety. A retrospective analysis of robotic-assisted surgery for all children under age of 18 years from June 2004 to November 2013 at King Khalid University Hospital was conducted. Data of demographic (age, sex, and weight), type of procedures, operative time, intraoperative and postoperative complications were noted. Seventy robot assisted laparoscopy procedures were performed using the da Vinci surgical system. All procedures except three cases were successfully completed using robot with mean operative time of 110 min. Nissen fundoplication (34 cases) was the commonest robotic surgical procedure performed followed by cholecystectomy, anal-pull through and gastric banding. There were no intraoperative and postoperative complications related to anesthesia. Robotic-assisted laparoscopy is a safe and feasible technique for a variety of pediatric procedures. Our findings suggest that, perioperative anesthesia care should be considered in advance with high anesthetic precautions to maximize patient safety and improve surgical outcome. It is worth to have more studies measuring clinical anesthesia outcome of pediatric robotic surgery.

Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review

“…After removing duplicates and title and abstract screening, 35 studies were assessed for eligibility through full-text evaluations. In the end, fifteen studies were considered eligible and included in the review ( Figure 1 ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Pediatric robotic surgery: issues in management—expert consensus from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP)

“…The number and type of peripheral vascular access points required during robotic surgery depends on the type of surgery [1,3,5], as well as the patient's age, weight, and clinical condition [54][55][56]. The situation will also depend on the patient's vascular history and the manual skills of the anesthesiologist.…”

“…The situation will also depend on the patient's vascular history and the manual skills of the anesthesiologist. Prior to surgery, the access points (venous and peripheral) must be properly fixed and controlled, given the potential difficulty of accessing the patient after docking [3].…”

“…Placement of a nasogastric tube before surgery enables decompression of the stomach, which is frequently inflated during the induction of anesthesia [3,64,65]. Decompression is critical in abdominal and urological RAS, because it improves the visibility of the operative field and minimizes the risk of accidental gastric damage [63,65,66].…”

Roboterassistierte (RA-)Kinderchirurgie: Nierenbeckenplastiken mit dem Da-Vinci-Roboter

“…Hierbei wurde auch die Alters-bzw. Gewichtsgrenze kontinuierlich nach unten korrigiert (2,5 Monate, 7 kg) [1,5,8,13]. Obwohl die RA-Chirurgie besonders in der Kinderurologie v. a. im Ausland immer weitere Verbreitung findet, liegen für Deutschland noch kaum Untersuchungen vor.…”