Implementing a pediatric robotic surgery program: future perspectives.

C Soto Beauregard, J Rodríguez de Alarcón García, E E Domínguez Amillo, M Gómez Cervantes, L F Ávila Ramírez
Author Information
  1. C Soto Beauregard: Pediatric Surgery Department. Institute for Children and Adolescents. San Carlos Clinical Hospital, Madrid (Spain).
  2. J Rodríguez de Alarcón García: Pediatric Surgery Department. Institute for Children and Adolescents. San Carlos Clinical Hospital, Madrid (Spain).
  3. E E Domínguez Amillo: Pediatric Surgery Department. Institute for Children and Adolescents. San Carlos Clinical Hospital, Madrid (Spain).
  4. M Gómez Cervantes: Pediatric Surgery Department. Institute for Children and Adolescents. San Carlos Clinical Hospital, Madrid (Spain).
  5. L F Ávila Ramírez: Pediatric Surgery Department. Institute for Children and Adolescents. San Carlos Clinical Hospital, Madrid (Spain).

Abstract

INTRODUCTION: The minimally invasive approach using robotic technology is fully incorporated in the treatment of adult pathologies. The first international pediatric studies with a robotic approach date from 2002, and in Spain, from 2009. We present the implementation of a Pediatric Robotic Surgery program in our setting.
MATERIALS AND METHODS: A proposal for the application of robotic technology in pediatrics was developed, and after the acquisition of a Da Vinci Xi system at our center, a program was initiated under the guidance of a pediatric surgeon experienced in this approach.
RESULTS: 732 patients with a median age of 12 years (7 months-17 years) have been operated on since January 2019. 56% of the procedures were abdominal. 3 thoracic approaches and 11 urologic procedures were carried out. 1 conversion to open surgery was performed during a fundoplication. The median combined duration of abdominal and thoracic approaches was 155 minutes (70-380 minutes). There were no anesthetic or hemodynamic complications. The postoperative period in the cases in which the procedure was completed was uneventful, and patients were discharged after a median of 2 days (1-16 days).
CONCLUSION: The main advantage of robotic procedures is the symmetrical movement in line with the surgeon's hands, which makes the learning curve shorter. In our experience, the robotic approach has allowed for greater precision in the surgical technique, favoring the patient's recovery.

Keywords

MeSH Term

Adult
Child
Fundoplication
Humans
Learning Curve
Robotic Surgical Procedures
Robotics
Specialties, Surgical

Word Cloud

Created with Highcharts 10.0.0roboticapproachpediatricPediatricmedianproceduressurgerytechnologyRoboticprogrampatientsyearsabdominalthoracicapproachesminutesdaysINTRODUCTION:minimallyinvasiveusingfullyincorporatedtreatmentadultpathologiesfirstinternationalstudiesdate2002Spain2009presentimplementationSurgerysettingMATERIALSANDMETHODS:proposalapplicationpediatricsdevelopedacquisitionDaVinciXisystemcenterinitiatedguidancesurgeonexperiencedRESULTS:732age127months-17operatedsinceJanuary201956%311urologiccarried1conversionopenperformedfundoplicationcombinedduration15570-380anesthetichemodynamiccomplicationspostoperativeperiodcasesprocedurecompleteduneventfuldischarged21-16CONCLUSION:mainadvantagesymmetricalmovementlinesurgeon'shandsmakeslearningcurveshorterexperienceallowedgreaterprecisionsurgicaltechniquefavoringpatient'srecoveryImplementingprogram:futureperspectivesurologylungresection

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