Robotic-assisted surgery in the pediatric surgeons’ world: Current situation and future prospectives

Abstract

Robotic-assisted surgery has been fully embraced by surgeons for the adult population; however, its acceptance is too slow in the world of pediatric surgeons. It is largely due to the technical limitations and the inherent high cost associated with it. In the past two decades, indeed, there has been considerable advancement in pediatric robotic surgery. A large number of surgical procedures were performed on children with the assistance of robots, even with comparative success rates to standard laparoscopy. As a newly developing field, it still has many challenges and obstacles. This work is centered on the current status and progression of pediatric robotic surgery as well as the future perspectives in the field of pediatric surgery.

Pyeloplasty in Children with Ureteropelvic Junction Obstruction and Associated Kidney Anomalies: Can a Robotic Approach Make Surgery Easier?

“…Moreover, the learning curve for suture placement in robotic surgery is shorter compared to laparoscopic surgery. The characteristics of the robotic system permit the passage from open to robot-assisted laparoscopic pyeloplasty without previous experience in conventional laparoscopy [ 38 , 39 , 40 , 41 ]. To accurately and safely perform surgery using a laparoscopic technique, it is necessary to have a high level of skill for difficult procedures that require time for reconstruction, such as laparoscopic intervention for UPJO.…”

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

“…One notable benefit of robotic-assisted surgery is the precision and enhanced dexterity afforded by robotic systems, crucial for navigating the intricate anatomical structures of both neonates and children. Studies indicate that the magnified, three-dimensional views and fine-tuned instruments provided by robotic systems enable surgeons to execute more accurate movements in confined spaces, thereby minimizing the risk of damage to delicate tissues [ 14 , 38 ].…”

“…The incorporation of robotic-assisted surgery in pediatric surgery is a significant progress in terms of enhancing precision, minimizing invasiveness, and broadening the range of surgical treatment options for young patients [ 13 , 14 ]. In recent years, there has been a growing trend in the use of robotic systems for pediatric treatments, following their initial development and widespread use in adult surgical settings.…”

“…This is due to the fact that these technologies offer unique solutions to address the specific challenges associated with operating on smaller, developing anatomies [ 13 , 15 ]. This growing specialty integrates the expertise of pediatric surgeons with modern robotics to revolutionize pediatric surgical procedures, with the aim of improving outcomes and the quality of treatment for children with complex medical conditions [ 14 ].…”

Robotic-assisted surgery for gynecological indications in children and adolescents: European multicenter report

“…Some major drawbacks must be considered before using RAS in children: anesthesia, placement of trocars, and technical difficulties related to small space [ 3 ]. Nevertheless, RAS has been described as safe and feasible option for a wide range of surgical indications in children, including urological, oncological, and gastrointestinal pathologies [ 4 – 8 ]. Several reports have investigated safety and feasibility of RAS in pediatric population, compared with different approaches (open or laparoscopic) [ 9 – 12 ].…”