Paediatric robotic surgery

Cave, Joshua J.; Clarke, Simon A.

doi:10.1308/rcsann.supp2.18

Cited by 35 publications

(37 citation statements)

References 64 publications

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“…Based on those small case series, robotic da Vinci surgery appears not to be critically harmful to infants, although data on collisions and complications relating to different age and weight groups are still missing. Whether a general recommendation should be given for robotic infant surgery based on the available case series has to be discussed: we propose a three step approach of evaluation of new robotic systems for application in infants (1. inanimate model, 2. live animal model, 3. comparison of open, laparoscopic and robotic procedures in live animal models).…”

Section: Comparison To Literature Results Of Infant Robotic Surgerymentioning

confidence: 99%

“…Furthermore, operative and surgical precision appear to be improved with magnification of the intraoperative vision and the use of smaller size instruments than in open surgery—a benefit especially in pediatric patients [ 2 ]. Robotic, or computer assisted minimally invasive surgery may also be beneficial for pediatric surgical procedures, especially due to enhanced 3D Vision, stabilized camera, reduction of tremor, and downscaling of movements [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Robotic infant surgery with 3 mm instruments: a study in piglets of less than 10 kg body weight

et al. 2021

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No data exist concerning the appication of a new robotic system with 3 mm instruments (Senhance®, Transenterix) in infants and small children. Therefore, the aim of this study was to test the system for its feasibility, performance and safety of robotic pediatric abdominal and thoracic surgery in piglets simulating infants with a body weight lower than 10 kg. 34 procedures (from explorative laparoscopy to thoracoscopic esophageal repair) were performed in 12 piglets with a median age of 23 (interquartile range: 12–28) days and a median body weight of 6.9 (6.1–7.3) kg. The Senhance® robotic system was used with 3 mm instruments, a 10 mm 3D 0° or 30° videoscope and advanced energy devices, the setup consisted of the master console and three separate arms. The amount, size, and position of the applied ports, their distance as well as the distance between the three operator arms of the robot, external and internal collisions, and complications of the procedures were recorded and analyzed. We were able to perform all planned surgical procedures with 3 mm robotic instruments in piglets with a median body weight of less than 7 kg. We encountered two non-robot associated complications (bleeding from the inferior caval and hepatic vein) which led to termination of the live procedures. Technical limitations were the reaction time and speed of robotic camera movement with eye tracking, the excessive bending of the 3 mm instruments and intermittent need of re-calibration of the fulcrum point. Robotic newborn and infant surgery appears technically feasible with the Senhance® system. Software adjustments for camera movement and sensitivity of the fulcrum point calibration algorithm to adjust for the increased compliance of the abdominal wall of infants, therefore reducing the bending of the instruments, need to be implemented by the manufacturer as a result of our study. To further evaluate the Senhance® system, prospective trials comparing it to open, laparoscopic and other robotic systems are needed.

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Section: Comparison To Literature Results Of Infant Robotic Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic infant surgery with 3 mm instruments: a study in piglets of less than 10 kg body weight

et al. 2021

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“…Reconstructive surgery such as esophageal and intestinal anastomosis, all of which require a delicate and more magnified approach will benefit enormously from these advances. The pediatric and neonatal patient must be at the forefront of research into the future of robotic surgery [173].…”

Section: The Future Of Robotic Surgery In Childrenmentioning

confidence: 99%

Robotic-Assisted Minimally Invasive Surgery in Children

Navarrete-Arellano¹

2021

Latest Developments in Medical Robotics Systems

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Currently, minimally invasive surgery (MIS) includes conventional laparo-thoracoscopic surgery and robot-assisted surgery (RAS) or robotic surgery. Robotic surgery is performed with robotic devices, for example the Da Vinci system from Intuitive Surgical, which has a miniaturized camera capable of image magnification, a three-dimensional image of the surgical field, and the instruments are articulated with 7 degrees of freedom of movement, and the surgeon operates in a sitting position at a surgical console near the patient. Robotic surgery has gained an enormous surge in use on adults, but it has been slowly accepted for children, although it offers important advantages in complex surgeries. The areas of application of robotic surgery in the pediatric population include urological, general surgery, thoracic, oncological, and otorhinolaryngology, the largest application has been in urological surgery. There is evidence that robotic surgery in children is safe and it is important to offer its benefits. Intraoperative complications are rare, and the frequency of postoperative complications ranges from 0–15%. Recommendations for the implementation of a pediatric robotic surgery program are included. The future will be fascinating with upcoming advancements in robotic surgical systems, the use of artificial intelligence, and digital surgery.

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“…Due to the magnification of the operative field, application of 3D technology and thus spatial vision, improved ergonomics for the surgeon and a greater range of motion of the robotic instruments compared to conventional laparoscopic instruments, robotic assisted minimally invasive surgery appears to be beneficial over conventional minimal invasive surgery, especially in complex reconstructive procedures [ 57 , 58 , 59 , 60 , 61 ].…”

Section: Reviewmentioning

confidence: 99%

Advances and Trends in Pediatric Minimally Invasive Surgery

Meinzer

Alkatout

Krebs

et al. 2020

JCM

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As many meta-analyses comparing pediatric minimally invasive to open surgery can be found in the literature, the aim of this review is to summarize the current state of minimally invasive pediatric surgery and specifically focus on the trends and developments which we expect in the upcoming years. Print and electronic databases were systematically searched for specific keywords, and cross-link searches with references found in the literature were added. Full-text articles were obtained, and eligibility criteria were applied independently. Pediatric minimally invasive surgery is a wide field, ranging from minimally invasive fetal surgery over microlaparoscopy in newborns to robotic surgery in adolescents. New techniques and devices, like natural orifice transluminal endoscopic surgery (NOTES), single-incision and endoscopic surgery, as well as the artificial uterus as a backup for surgery in preterm fetuses, all contribute to the development of less invasive procedures for children. In spite of all promising technical developments which will definitely change the way pediatric surgeons will perform minimally invasive procedures in the upcoming years, one must bear in mind that only hard data of prospective randomized controlled and double-blind trials can validate whether these techniques and devices really improve the surgical outcome of our patients.

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Paediatric robotic surgery

Abstract: A review of the current status of robotic surgery use in paediatrics.

Cited by 35 publications

References 64 publications

Robotic infant surgery with 3 mm instruments: a study in piglets of less than 10 kg body weight

Robotic infant surgery with 3 mm instruments: a study in piglets of less than 10 kg body weight

Robotic-Assisted Minimally Invasive Surgery in Children

Advances and Trends in Pediatric Minimally Invasive Surgery

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