Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

Cundy, Thomas P.; Marcus, Hani J.; Clark, James E.; Hughes-Hallett, Archie; Mayer, Erik; Najmaldin, Azad; Yang, Guang‐Zhong; Darzi, Ara

doi:10.1055/s-0033-1347297

Cited by 17 publications

(8 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are benefits and limitations of using robotic surgery for children with cancer (74), it is feasible for the surgical treatment of tumors in pediatric patients and only isolated adverse events have been reported for malignant tumors, such as tumor spillage and residual disease (45). The current status of robotic surgery for tumors in children is low volume usage, in a relatively static global state of adoption and when applied the oncological surgical principles must be respected (46, 47).…”

Section: Discussionmentioning

confidence: 99%

“…Because there has been an increasing availability of smaller instruments and equipment more suitable to the pediatric patient, for conventional laparo-thoracoscopy, there has been an increase in the use of these techniques with children. With robotic assistance there are also risks, among others, are port-site metastases and peritoneal spread, after resection due to minimal invasion of neoplasms (44, 45). The current status of robotic surgery for tumors in children is low volume usage, and globally a relatively static adoption (46–48).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Arellano

González

2019

Front. Pediatr.

View full text Add to dashboard Cite

Objective: We present the applications and experiences of robot-assisted laparoscopic and thoracoscopic surgery (RALTS) in pediatric surgery. Materials and Methods: A prospective, observational, and longitudinal study was conducted from March 2015 to March 2018 that involved a non-random sample of a pediatric population that was treated with RALTS. The parameters examined were: gender, age, weight, height, diagnoses, surgical technique, elapsed time of console surgery, estimated bleeding, need for hemotransfusion, complications, surgical conversions, postoperative hospital stay, and follow-up. The Clavien-Dindo classification of complications was used. The surgical system used was the da Vinci model, Si version (Intuitive Surgical, Inc., Sunnyvale, CA. U.S.A), with measures of central tendency. Results: In a 36-months period, 186 RALTS cases were performed, in 147 pediatric patients and an adult; 53.23% were male, and the remaining were female. The average age was 83 months, ranging from 3.5 to 204 months, plus one adult patient of 63 years. The stature was an average of 116.6 cm, with a range of 55–185 cm; the average weight was 26.9 kg, with a range of 5–102 kg; the smallest patient at 3.5 months was 55 cm in stature and weighed 5.5 kg. We performed 41 different surgical techniques, grouped in 4 areas: urological 91, gastrointestinal and hepatobiliary (GI-HB) 84, thoracic 6, and oncological 5. The console surgery time was 137.2 min on average, ranging from 10 to 780 min. Surgeon 1 performed 154 operations (82.8%), and the remainder were performed by Surgeon 2, with a conversion rate of 3.76%. The most commonly performed surgeries were: pyeloplasty, fundoplication, diaphragmatic plication, and removal of benign tumors, by area. Hemotransfusion was performed for 4.83%, and complications occurred in 2.68%. The average postoperative stay was 2.58 days, and the average follow-up was 23.5 months. The results of the 4 areas were analyzed in detail. Conclusion: RALTS is safe and effective in children. An enormous variety of surgeries can be safely performed, including complex hepatobiliary, and thoracic surgery in small children. There are few published prospective series describing RALTS in the pediatric population, and most only describe urological surgery. It is important to offer children the advantages and safety of minimal invasion with robotic assistance; however, this procedure has only been slowly accepted and utilized for children. It is possible to implement a robust program of pediatric robotic surgery where multiple procedures are performed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Arellano

González

2019

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Minimal invasive surgery is strongly discouraged when malignancy is suspected (Level III; Grade E). Therefore, minimally invasive techniques in the surgical management of ACT are not recommended, even when they are feasible, 30–34 and could only be considered in early childhood, but their use should be limited to (a) small‐volume localised tumours likely to be benign without invasion of surrounding structures and nodal involvement at preoperative imaging; and (b) tertiary care centres and surgeons experienced in oncologic and adrenal surgery (Level IV; Grade D). In particular, tumours with a volume exceeding 200 cm 3 and/or suspicious regional nodal involvement and/or signs of local invasion should always be resected using an open laparotomy, with no exceptions (Level IV; Grade B).…”

Section: Therapeutic Recommendationsmentioning

confidence: 99%

Adrenocortical tumours in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Virgone

Roganović

Vorwerk

et al. 2021

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Adrenocortical tumours (ACTs) are rare during childhood. A complete surgical resection provides the best chance of cure, but the role and efficacy of the adjuvant therapy are still controversial. Various histologic criteria of malignancy for ACTs adopted in children do not facilitate comparative studies and are not completely shared. Therefore, a sharp demarcation between benign and malignant lesions has not been recog-

show abstract

“…Pediatric cancer surgery is an area of opportunity for robotic surgery. Its technical challenges create the opportunity to develop robotic approaches that meet the challenges of complex cancer procedures [151].…”

Section: Oncologic Robotic Surgerymentioning

confidence: 99%

Robotic-Assisted Minimally Invasive Surgery in Children

Navarrete-Arellano¹

2021

Latest Developments in Medical Robotics Systems

View full text Add to dashboard Cite

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.

show abstract

Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

Cited by 17 publications

References 46 publications

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Robot-Assisted Laparoscopic and Thoracoscopic Surgery: Prospective Series of 186 Pediatric Surgeries

Adrenocortical tumours in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Robotic-Assisted Minimally Invasive Surgery in Children

Contact Info

Product

Resources

About