How to decide which infant can have robotic surgery? Just do the math

Finkelstein, Julia B.; Levy, AC; Silva, M.V.; Murray, Laurie; Delaney, C.; Casale, Pasquale

doi:10.1016/j.jpurol.2014.11.020

Cited by 58 publications

(28 citation statements)

References 16 publications

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“…Mini‐invasive HN is even more demanding and technically difficult in young children because of their small abdomen size . The impact of the limited anatomical workspace in toddlers is still a matter of debate in the field of minimally invasive surgery . Thus, some authors reported significant functional loss of the residual moiety, and advocated for the use of an open approach in children aged <1 year .…”

Section: Introductionmentioning

confidence: 99%

“…8 The impact of the limited anatomical workspace in toddlers is still a matter of debate in the field of minimally invasive surgery. 9 Thus, some authors reported significant functional loss of the residual moiety, and advocated for the use of an open approach in children aged <1 year. 10 In this population, standard transperitoneal laparoscopic or retroperitoneoscopic HN approaches were recently reported to be safe and to have a low conversion rate.…”

Section: Introductionmentioning

confidence: 99%

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Partial nephrectomy for small children: Robot‐assisted versus open surgery

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Partial nephrectomy for small children: Robot‐assisted versus open surgery

et al. 2017

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“…Trocar placement is a crucial step in robotic-assisted surgery in order to minimize instrument collision and operative time. A recent study demonstrated that collisions are minimized if the distance between both anterior superior iliac spines is >13 cm, or if the puboxyphoid distance is >15 cm (19).…”

Section: Trocar Placementmentioning

confidence: 99%

Robotic-Assisted Urologic Surgery in Infants: Positioning, Trocar Placement, and Physiological Considerations

2019

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Pediatric robotic-assisted laparoscopic procedures are becoming increasingly common. They have been shown to be safe in younger patients, including infants. Successful adoption of robotic-assisted surgery in infants requires an understanding of the technical factors unique to this patient population. This review will delineate the specific considerations to safely perform robotic-assisted laparoscopic procedures in infants, including physiological changes associated with pneumoperitoneum in infants, positioning, trocar placement, and docking.

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“… [5] found that operative times, hospital stay, and postoperative outcomes were similar in children greater than or less than 15 kg, with only longer robotic set-up times for patients less than 15 kg, and Finkelstein et al. [6] found that at least a 13 cm distance between anterior superior iliac spines (for lower urinary tract procedures) and at least a 15 cm puboxyphoid (for upper urinary tract procedures) can aid in selecting infants for robotic surgery.…”

Section: Introductionmentioning

confidence: 99%

Robotic surgery in pediatric urology

Howe

Kozel

Palmer

2017

Asian Journal of Urology

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While robotic surgery has shown clear utility and advantages in the adult population, its role in pediatrics remains controversial. Pediatric-sized robotic instruments and equipment are not readily available yet, so certain modifications can be made in order to make robotic surgery successful in children. While the cost of robotic surgery remains high compared to open procedures, patients experience greater satisfaction and quality of life with robotic surgery. Robotic pyeloplasty is a standard of care in older children, and has even been performed in infants and re-do surgery. Other robotic procedures performed in children include heminephroureterectomy, ureteroureterostomy, ureteral reimplantation, urachal cyst excision, bladder diverticulectomy, and bladder reconstructive procedures such as augmentation, appendicovesicostomy, antegrade continence enema, bladder neck reconstruction and sling, as well as other procedures. Robotic surgery has also been used in oncologic cases such as partial nephrectomy and retroperitoneal lymph node dissection. Future improvements in technology with production of pediatric-sized robotic instruments, along with increases in robotic-trained pediatric urologists and surgeon experience along each's learning curve, will help to further advance the field of robotic surgery in pediatric urology.

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How to decide which infant can have robotic surgery? Just do the math

Cited by 58 publications

References 16 publications

Partial nephrectomy for small children: Robot‐assisted versus open surgery

Partial nephrectomy for small children: Robot‐assisted versus open surgery

Robotic-Assisted Urologic Surgery in Infants: Positioning, Trocar Placement, and Physiological Considerations

Robotic surgery in pediatric urology

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