Paediatric robotic surgery: a narrative review

Abstract

The benefits of minimally invasive surgery (MIS) compared with traditional open surgery, including reduced postoperative pain and a reduced length of stay, are well recognised. A significant barrier for MIS in paediatric populations has been the technical challenge posed by laparoscopic surgery in small working spaces, where rigid instruments and restrictive working angles act as barriers to safe dissection. Thus, open surgery remains commonplace in paediatrics, particularly for complex major surgery and for surgical oncology. Robotic surgical platforms have been designed to overcome the limitations of laparoscopic surgery by offering a stable 3-dimensional view, improved ergonomics and greater range of motion. Such advantages may be particularly beneficial in paediatric surgery by empowering the surgeon to perform MIS in the smaller working spaces found in children, particularly in cases that may demand intracorporeal suturing and anastomosis. However, some reservations have been raised regarding the utilisation of robotic platforms in children, including elevated cost, an increased operative time and a lack of dedicated paediatric equipment. This article aims to review the current role of robotics within the field of paediatric surgery.

Small Scale, High Precision: Robotic Surgery in Neonatal and Pediatric Patients—A Narrative Review

“…The findings suggest that patients undergoing robotic-assisted surgery, particularly children and their caregivers, experience reduced postoperative stress and anxiety. Moreover, the precise movements and enhanced visualization provided by robotic systems may instill confidence in caregivers, alleviating concerns about potential complications [ 13 , 43 ].…”

Robotic surgeries in pediatric patients: an early experience in a single center

“…Robotic surgery has the advantages of 3-dimensional view, optical magnification, motional scaling, and improved ergonomics and degree of freedom [ 1 2 3 4 5 6 7 8 9 ]. The first case of robot-assisted surgery in a pediatric patient using a da Vinci platform (Intuitive Surgical, Inc.) was reported in 2001 [ 10 ].…”

“…In consequence, securing sufficient space between trocar sites is difficult. It can easily induce collision of robotic arms and limited visualized operative field [ 7 8 11 12 ]. Increased operative time, high financial cost, and absence of haptic feedback are also well-known drawbacks of robot-assisted surgery [ 4 ].…”

Feasibility and Safety of Robotic Assisted Surgical Approach in Median Arcuate Ligament Syndrome – A Systematic Review

“…Robotic surgery provided stable surgeon controlled 3-dimensional view, better ergonomics, tremor ltration, improved intra-corporeal movements of instruments, precise dissection, and better post-operative pain control and similar or shorter hospital stay. At present increased initial robotic program cost, is the major disadvantages[29,30,31].The aim of treatment in MALS is precise and circumferential division of MAL bres to restore normal blood ow. Though open-MALR was the main stay till last decade, laparoscopic approach gained popularity due to its advantages.…”