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Robotic-assisted laparoscopic surgery for pediatric tumors: a bicenter experience

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Abstract

Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial. 12 robotic-assisted tumor resections with the da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA) were attempted in 11 children (mean age 7.65 years; age range 0.75–16.75 years; mean weight 30.3 kg; weight range 8.6–62 kg) in two centers. Mean total operative time was 145 min (range 72–263 min). 1 procedure (8.3%) was converted. The pathology included renal tumors (n = 2; one nephroblastoma, one metanephric adenoma), adrenal tumors (n = 9; three neuroblastomas, two pheochromocytomas, two adrenocortical adenomas, one cystic lymphangioma, one paraganglioma) and a pancreatic tumor (n = 1; one pancreatic cyst). 4 tumors (33.3%) were malignant. Every patient underwent a R0 resection. 1 child (8.3%) developed a post operative complication. Mean length of hospitalization was 3.0 days (range 2–5 days). Followup averaged 3.3 years with no recurrence. All children are alive. Robot-assisted MIS seems to be safe and feasible in pediatric tumors. The oncological surgical principles were respected in our series with low morbi/mortality and good long-term results. Robotic surgery and its technical advantages bring potential benefits for children with cancer. It has a role to play in pediatric oncological surgery but its place and indications still need to be better defined.

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Funding

This study was not funded.

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Authors and Affiliations

  1. Service de chirurgie viscérale pédiatrique, Hôpital de Clocheville-CHU de TOURS, 49 boulevard Béranger, 37044, Tours Cedex, France

    P. Meignan, K. Braik, A. R. Cook, H. Lardy & Aurélien Binet

  2. Service de chirurgie viscérale pédiatrique, Hôpital des Enfants, 8 avenue Dominique Larrey, 87042, Limoges Cedex, France

    Q. Ballouhey, B. Longis & L. Fourcade

  3. Service d’onco-hématologie pédiatrique, Hôpital de Clocheville, 49 boulevard Béranger, 37044, Tours Cedex, France

    J. Lejeune

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  1. P. Meignan
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  2. Q. Ballouhey
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  3. J. Lejeune
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  4. K. Braik
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  5. B. Longis
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  6. A. R. Cook
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  7. H. Lardy
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  8. L. Fourcade
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  9. Aurélien Binet
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Correspondence to Aurélien Binet.

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Conflict of interest

P. Meignan, Q. Ballouhey, J. Lejeune, K. Braik, B. Longis, A. R. Cook, H. Lardy, L. Fourcade and A. Binet have nothing to disclose and declare no conflicts of interest or financial ties to disclose.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Meignan, P., Ballouhey, Q., Lejeune, J. et al. Robotic-assisted laparoscopic surgery for pediatric tumors: a bicenter experience. J Robotic Surg 12, 501–508 (2018). https://doi.org/10.1007/s11701-017-0773-2

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  • DOI: https://doi.org/10.1007/s11701-017-0773-2

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