Robotic Surgery in Pediatric Oncology: Lessons Learned from the First 100 Tumors—A Nationwide Experience

Blanc, Thomas; Meignan, Pierre; Vinit, Nicolas; Ballouhey, Quentin; Pio, Lucas; Capito, Carmen; Harte, Caroline; Vatta, Fabrizio; Galmiche-Rolland, Louise; Minard, Véronique; Orbach, Daniel; Muller, Cécile; Kohaut, Jules; Broch, Aline; Braik, Karim; Binet, Aurélien; Héloury, Yves; Fourcade, Laurent; Lardy, H.; Sarnacki, Sabine

doi:10.1245/s10434-021-10777-6

Cited by 27 publications

(38 citation statements)

References 32 publications

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“…The most extensive prospective series of RAS in pediatric oncology was published in 2021 [ 47 ]. Between 2016 and 2020, 100 tumors were operated on in 89 children.…”

Section: Resultsmentioning

confidence: 99%

Robotically Assisted Surgery in Children—A Perspective

Krebs

Schnorr

Heye³

et al. 2022

Children

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The introduction of robotically assisted surgery was a milestone for minimally invasive surgery in the 21st century. Currently, there are two FDA-approved robotically assisted surgery systems for use and development in pediatrics. Specifically, tremor filtration and optimal visualization are approaches which can have enormous benefits for procedures in small bodies. Robotically assisted surgery in children might have advantages compared to laparoscopic or open approaches. This review focuses on the research literature regarding robotically assisted surgery that has been published within the past decade. A literature search was conducted to identify studies comparing robotically assisted surgery with laparoscopic and open approaches. While reported applications in urology were the most cited, three other fields (gynecology, general surgery, and “others”) were also identified. In total, 36 of the publications reviewed suggested that robotically assisted surgery was a good alternative for pediatric procedures. After several years of experience of this surgery, a strong learning curve was evident in the literature. However, some authors have highlighted limitations, such as high cost and a limited spectrum of small-sized instruments. The recent introduction of reusable 3 mm instruments to the market might help to overcome these limitations. In the future, it can be anticipated that there will be a broader range of applications for robotically assisted surgery in selected pediatric surgeries, especially as surgical skills continue to improve and further system innovations emerge.

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“…The most extensive prospective series of RAS in pediatric oncology was published in 2021 [ 47 ]. Between 2016 and 2020, 100 tumors were operated on in 89 children.…”

Section: Resultsmentioning

confidence: 99%

Robotically Assisted Surgery in Children—A Perspective

Krebs

Schnorr

Heye³

et al. 2022

Children

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“…Low-grade thymomas have a favorable outcome after complete tumor resection. A complete resection including the whole thymus, performed through classical median sternotomy, video-assisted techniques, or robotic approach, is the mainstay of treatment in TET ( 9 , 10 ). The literature highlights the importance of complete resection in thymoma in early stages as well as the need for neoadjuvant chemotherapy when an aggressive histologic subtype is demonstrated, especially in case of mediastinal lymph node dissemination ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Thymic tumors in children, very rare tumors requiring international cooperation: extended abstract

Orbach¹,

Philippe‐Chomette²,

Brisse³

et al. 2022

Mediastinum

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“…Lastly, oncological pediatric surgery deserves a special mention about RAS. Undoubtedly, RAS is rare in pediatric oncology due to the rarity of pediatric tumors, and the principal matter of debate remains whether the fundamental oncological principles of no spillage and total resection of the margins can be ful lled with the use of RAS [6,35,45].…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Surgery in Pediatrics: What Is Evidence-Based? A Review of the Literature

Boscarelli

Giglione

Caputo

et al. 2022

Preprint

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Aim of the study: This study examines evidence-based indications for robotic-assisted surgery (RAS) in the different fields of pediatric surgery.Methods: A systematic database search (MEDLINE, Scopus, Web of Science) was performed to identify articles covering any aspect of RAS in the pediatric population. Using Boolean operators AND/OR, all possible combinations of the following search terms were used: robotic surgery, pediatrics, neonatal surgery, thoracic surgery, abdominal surgery, urologic surgery, hepatobiliary surgery, and surgical oncology. The selection criteria were limited to the English language, pediatric patients (under 18 years of age), and articles published after 2010.Main Results: A total of 239 abstracts were reviewed. Of these, 10 published articles met the purposes of our study with a level of evidence I/II and therefore were analyzed. Notably, most of the articles included in this review reported evidence-based indications in urological surgery.Conclusions: According to this study, the exclusive indications for RAS in the pediatric population are pyeloplasty for ureteropelvic junction obstruction in older children and ureteral reimplantation according to the Lich-Gregoire technique in selected cases for the need to access the pelvis with a narrow anatomical and working space. All other indications for RAS in pediatric surgery are still under discussion to date, and cannot be supported by papers with a high level of evidence. However, RAS is certainly a promising technology. Further evidence is strongly encouraged in the future.

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Robotic Surgery in Pediatric Oncology: Lessons Learned from the First 100 Tumors—A Nationwide Experience

Cited by 27 publications

References 32 publications

Robotically Assisted Surgery in Children—A Perspective

Robotically Assisted Surgery in Children—A Perspective

Thymic tumors in children, very rare tumors requiring international cooperation: extended abstract

Robotic-Assisted Surgery in Pediatrics: What Is Evidence-Based? A Review of the Literature

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