World Journal of Surgery

, Volume 34, Issue 5, pp 975–978 | Cite as

Robot-Assisted Pediatric Surgery: How Far Can We Go?

  • Aayed Alqahtani
  • Abdullrahman Albassam
  • Mohammed Zamakhshary
  • Mohammed Shoukri
  • Tariq Altokhais
  • Ayman Aljazairi
  • Abdullrhman Alzahim
  • Mohammed Mallik
  • Abdullah Alshehri
Article

Abstract

Background

The purpose of this study was to assess the safety and feasibility of performing robot-assisted pediatric surgery using the da Vinci Surgical System in a variety of surgical procedures.

Methods

A retrospective review of 144 robot-assisted pediatric surgical procedures performed in our institution between June 2004 and December 2007 was done. The procedures included the following: 39 fundoplications; 34 cholecystectomies; 25 gastric bandings; 13 splenectomies; 4 anorectal pull-through operations for imperforate anus; 4 nephrectomies; 4 appendectomies; 4 sympathectomies; 3 choledochal cyst excisions with hepaticojejunostomies; 3 inguinal hernia repairs; two each of the following: liver cyst excision, repair of congenital diaphragmatic hernia, Heller’s myotomy, and ovarian cyst excision; and one each of the following: duodeno-duodenostomy, adrenalectomy, and hysterectomy.

Results

A total of 134 procedures were successfully completed without conversion; 7 additional cases were converted to open surgery, and 3 were converted to laparoscopic surgery. There were no system failures (e.g., setup joint, arm, or camera malfunction; power error; monocular or binocular loss; metal fatigue or break of surgeon’s console hand piece; software incompatibility). There was one esophageal perforation and two cases of transient dysphagia following Nissen fundoplication. The mean patient age was 8.9 years, and the mean patient weight was 57 kg.

Conclusions

Robot-assisted surgery appears to be safe and feasible for a number of pediatric surgical procedures. Further system improvement and randomized studies are required to evaluate the benefits, if any, and the long-term outcomes of robotic surgery.

References

  1. 1.
    Diodato MD, Damiano RJ Jr (2003) Robotic cardiac surgery: overview. Surg Clin North Am 83:1351–1367CrossRefPubMedGoogle Scholar
  2. 2.
    Falk V, Diegler A, Walther T et al (2000) Developments in robotic cardiac surgery. Curr Opin Cardiol 15:378–387CrossRefPubMedGoogle Scholar
  3. 3.
    Satava RM (1999) Emerging technologies for surgery in the 21st century. Arch Surg 134:1197–1202CrossRefPubMedGoogle Scholar
  4. 4.
    Ballantyne GH, Moll F (2003) The da Vinci telerobotic surgical system: the virtual operative field and telepresence surgery. Surg Clin North Am 83:1293–1304CrossRefPubMedGoogle Scholar
  5. 5.
    Alqahtani AR, Albassam A (2005) Experience with da Vinci robot-assisted procedures in children. J Laparoendosc Adv Surg Tech 15:201–216CrossRefGoogle Scholar
  6. 6.
    Woo R, Le D, Kim S et al (2006) Robot-assisted laparoscopic resection of a type I choldedochal cyst. J Laparoendosc Adv Tech 16:179–183CrossRefGoogle Scholar
  7. 7.
    Goh PMY, Lomanto D, So JBY (2002) Robotic-assisted laparoscopic cholecystectomy. Surg Endosc 16:216–217CrossRefPubMedGoogle Scholar
  8. 8.
    Lorincz A, Langenburg S, Klein MD (2003) Robotics and the pediatric surgeon. Curr Opin Pediatr 15:262–266CrossRefPubMedGoogle Scholar
  9. 9.
    Zhou HX, Guo YH, Yu XF et al (2006) Zeus robot-assisted laparoscopic cholecystectomy in comparison with conventional laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int 5:115–118PubMedGoogle Scholar
  10. 10.
    Alqahtanin AR (2007) Robotic gastric banding in adolescents and children: a comparative study. J Laparoendosc Adv Surg Tech 17:533–534Google Scholar
  11. 11.
    Chaer RA, Jacobsen G, Elli F et al (2004) Robotic-assisted laparoscopic pediatric Heller’s cardiomyotomy: initial case report. J Laparoendosc Adv Surg Tech 14:270–273CrossRefGoogle Scholar
  12. 12.
    Atug F, Woods M, Burgess SV et al (2005) Robotic assisted laparoscopic pyeloplasty in children. J Urol 174:1440–1442CrossRefPubMedGoogle Scholar
  13. 13.
    Knight CG, Gidell KM, Lanning D et al (2005) Laparoscopic Morgagni hernia repair in children using robotic instruments. J Laparoendosc Adv Surg Tech 15:482–486CrossRefGoogle Scholar
  14. 14.
    Chandra V, Dutta S, Albanese CT (2006) Surgical robotics and image guided therapy in pediatric surgery: emerging and converging minimal access technologies. Semin Pediatr Surg 15:267–275CrossRefPubMedGoogle Scholar
  15. 15.
    Mikhail AA, Orvieto MA, Billatos ES et al (2006) Robotic-assisted laparoscopic prostatectomy: first 100 patients with one year of follow-up. Urology 68:1275–1279CrossRefPubMedGoogle Scholar
  16. 16.
    Cadiere GB, Himpens J, Germay O et al (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25:1467PubMedGoogle Scholar
  17. 17.
    AL-Qahatni AR, Almaramhi H (2006) Minimal access surgery in neonates and infants. J Pediatr Surg 41:910–913CrossRefGoogle Scholar
  18. 18.
    Velde EA, Bax NM, Tytgat SH et al (2008) Minimally invasive pediatric surgery: increasing implementation in daily practice and resident’s training. Surg Endosc 22:163–166CrossRefGoogle Scholar
  19. 19.
    Heller K, Gutt C, Schaeff B et al (2002) Use of the robot system da Vinci for laparoscopic repair of gastrooesophageal reflux in children. Eur J Pediatr Surg 12:239–242CrossRefPubMedGoogle Scholar
  20. 20.
    Cadiere GB, Himpens J, Vertruyen M et al (2001) Evaluation of telesurgical (robotic) Nissen fundoplication. Surg Endosc 15:918–923CrossRefPubMedGoogle Scholar
  21. 21.
    Albassam AA, Mallick MS, Gado A et al (2009) Nissen fundoplication, robotic-assisted versus laparoscopic procedure: a comparative study in children. Eur J Pediatr Surg 19:179–183CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Aayed Alqahtani
    • 1
  • Abdullrahman Albassam
    • 1
  • Mohammed Zamakhshary
    • 2
  • Mohammed Shoukri
    • 1
  • Tariq Altokhais
    • 1
  • Ayman Aljazairi
    • 1
  • Abdullrhman Alzahim
    • 1
  • Mohammed Mallik
    • 1
  • Abdullah Alshehri
    • 1
  1. 1.Division of Pediatric Surgery, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Division of Pediatric SurgeryKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia

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