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11, 2022;36 (11): 7877-7897.

Pediatric robotic surgery: issues in management-expert consensus from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP).

Simonetta Tesoro, Piergiorgio Gamba, Mirko Bertozzi, Rachele Borgogni, Fabio Caramelli, Giovanni Cobellis, Giuseppe Cortese, Ciro Esposito, Tommaso Gargano, Rossella Garra, Giulia Mantovani, Laura Marchesini, Simonetta Mencherini, Mario Messina, Gerald Rogan Neba, Gloria Pelizzo, Simone Pizzi, Giovanna Riccipetitoni, Alessandro Simonini, Costanza Tognon, Mario Lima
Author Information
  1. Simonetta Tesoro: Division of Anesthesia, Analgesia, and Intensive Care, Santa Maria della Misericordia University Hospital, Perugia, Italy.
  2. Piergiorgio Gamba: Pediatric Surgery, Department of Women's and Children's Health, University of Padua, 35128, Padua, Italy. piergiorgio.gamba@unipd.it.
  3. Mirko Bertozzi: Department of Pediatric Surgery, IRCCS San Matteo Polyclinic, University of Pavia, Pavia, Italy.
  4. Rachele Borgogni: Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy.
  5. Fabio Caramelli: Anesthesia and Intensive Care Unit, IRCCS Sant'Orsola Polyclinic, Bologna, Italy.
  6. Giovanni Cobellis: Pediatric Surgery Unit, Salesi Children's Hospital, Polytechnical University of Marche, Ancona, Italy.
  7. Giuseppe Cortese: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
  8. Ciro Esposito: Pediatric Surgery Unit, Federico II University of Naples, Naples, Italy.
  9. Tommaso Gargano: Pediatric Surgery Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
  10. Rossella Garra: Institute of Anesthesia and Intensive Care, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy.
  11. Giulia Mantovani: Pediatric Anesthesia, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.
  12. Laura Marchesini: Division of Anesthesia, Analgesia, and Intensive Care, Santa Maria della Misericordia University Hospital, Perugia, Italy.
  13. Simonetta Mencherini: Anesthesiology and Intensive Care Unit, Fondazione IRCCS San Matteo Polyclinic, Pavia, Italy.
  14. Mario Messina: Division of Pediatric Surgery, Santa Maria Alle Scotte Polyclinic, University of Siena, Siena, Italy.
  15. Gerald Rogan Neba: Department of Pediatric Anesthesia and Intensive Care, Salesi Children's Hospital, Ancona, Italy.
  16. Gloria Pelizzo: Pediatric Surgery Department, Vittore Buzzi' Children's Hospital, Milan, Italy.
  17. Simone Pizzi: Department of Pediatric Anesthesia and Intensive Care, Salesi Children's Hospital, Ancona, Italy.
  18. Giovanna Riccipetitoni: Department of Pediatric Surgery, IRCCS San Matteo Polyclinic, University of Pavia, Pavia, Italy.
  19. Alessandro Simonini: Department of Pediatric Anesthesia and Intensive Care, Salesi Children's Hospital, Ancona, Italy.
  20. Costanza Tognon: Pediatric Anesthesia, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.
  21. Mario Lima: Pediatric Surgery Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
PMID: 36121503 DOI: 10.1007/s00464-022-09577-0

Abstract

BACKGROUND: Pediatric robotic-assisted surgeries have increased in recent years; however, guidance documents are still lacking. This study aimed to develop evidence-based recommendations, or best practice statements when evidence is lacking or inadequate, to assist surgical teams internationally.
METHODS: A joint consensus taskforce of anesthesiologists and surgeons from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP) have identified critical areas and reviewed the available evidence. The taskforce comprised 21 experts representing the fields of anesthesia (n = 11) and surgery (n = 10) from clinical centers performing pediatric robotic surgery in the Italian cities of Ancona, Bologna, Milan, Naples, Padua, Pavia, Perugia, Rome, Siena, and Verona. Between December 2020 and September 2021, three meetings, two Delphi rounds, and a final consensus conference took place.
RESULTS: During the first planning meeting, the panel agreed on the specific objectives, the definitions to apply, and precise methodology. The project was structured into three subtopics: (i) preoperative patient assessment and preparation; (ii) intraoperative management (surgical and anesthesiologic); and (iii) postoperative procedures. Within these phases, the panel agreed to address a total of 18 relevant areas, which spanned preoperative patient assessment and patient selection, anesthesiology, critical care medicine, respiratory care, prevention of postoperative nausea and vomiting, and pain management.
CONCLUSION: Collaboration among surgeons and anesthesiologists will be increasingly important for achieving safe and effective RAS procedures. These recommendations will provide a review for those who already have relevant experience and should be particularly useful for those starting a new program.

Keywords

Anesthesiology Consensus Pediatric minimally invasive surgery Pediatric robotically assisted surgery

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MeSH Term

Infant, Newborn
Child
Humans
Anesthesiology
Robotic Surgical Procedures
Anesthesia
Consensus
Critical Care
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 8

Word Cloud

Created with Highcharts 10.0.0PediatricItalianSocietysurgeryconsensuspatientlackingrecommendationsevidencesurgicaltaskforceanesthesiologistssurgeonsNeonatalAnesthesiaIntensiveCareSARNePISurgerySICPcriticalareasroboticthreepanelagreedpreoperativeassessmentmanagementpostoperativeproceduresrelevantcarewillBACKGROUND:robotic-assistedsurgeriesincreasedrecentyearshoweverguidancedocumentsstillstudyaimeddevelopevidence-basedbestpracticestatementsinadequateassistteamsinternationallyMETHODS:jointidentifiedreviewedavailablecomprised21expertsrepresentingfieldsanesthesian = 11n = 10clinicalcentersperformingpediatriccitiesAnconaBolognaMilanNaplesPaduaPaviaPerugiaRomeSienaVeronaDecember2020September2021meetingstwoDelphiroundsfinalconferencetookplaceRESULTS:firstplanningmeetingspecificobjectivesdefinitionsapplyprecisemethodologyprojectstructuredsubtopics:preparationiiintraoperativeanesthesiologiciiiWithinphasesaddresstotal18spannedselectionanesthesiologymedicinerespiratorypreventionnauseavomitingpainCONCLUSION:CollaborationamongincreasinglyimportantachievingsafeeffectiveRASprovidereviewalreadyexperienceparticularlyusefulstartingnewprogramsurgery:issuesmanagement-expertAnesthesiologyConsensusminimallyinvasiveroboticallyassisted

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