Advertisement

Anesthesia experience of pediatric robotic surgery in a University Hospital

  • Wadha Mubarak Alotaibi
Original Article
  • 45 Downloads

Abstract

Robotic technology has a promising future in surgical field. Robotic-assisted laparoscopy is a newly advance technology which is highly accepted by most of surgeons in various surgical procedures. As the pediatric surgeons adopt and master robotic technique, anesthesiologists familiarized themselves with this technique as well. Robotic surgery required a high-quality of perioperative anesthesia care that is essential for optimizing surgical outcome and patient safety. A retrospective analysis of robotic-assisted surgery for all children under age of 18 years from June 2004 to November 2013 at King Khalid University Hospital was conducted. Data of demographic (age, sex, and weight), type of procedures, operative time, intraoperative and postoperative complications were noted. Seventy robot assisted laparoscopy procedures were performed using the da Vinci surgical system. All procedures except three cases were successfully completed using robot with mean operative time of 110 min. Nissen fundoplication (34 cases) was the commonest robotic surgical procedure performed followed by cholecystectomy, anal-pull through and gastric banding. There were no intraoperative and postoperative complications related to anesthesia. Robotic-assisted laparoscopy is a safe and feasible technique for a variety of pediatric procedures. Our findings suggest that, perioperative anesthesia care should be considered in advance with high anesthetic precautions to maximize patient safety and improve surgical outcome. It is worth to have more studies measuring clinical anesthesia outcome of pediatric robotic surgery.

Keywords

Robotic-assisted surgery system Pediatric surgery Perioperative anesthesia care 

Notes

Funding

None.

Compliance with ethical standards

Ethical approval

Ethical approval was sought form Institutional Review Board at College of Medicine.

Conflict of interest

Author declares that she has no conflict of interest.

Informed consent

Not applicable.

References

  1. 1.
    Reynolds W (2001) The first laparoscopic cholecystectomy. JSLS 5:89–94PubMedPubMedCentralGoogle Scholar
  2. 2.
    Sullivan MJ, Frost EAM, Lew MW (2008) Anesthetic care of the patient for robotic surgery. Middle East J Anaesthesiol 19:967–982PubMedGoogle Scholar
  3. 3.
    Lanfranco AR, Castellanos AE, Desai JP, Meyers WC (2004) Robotic surgery: a current perspective. Ann Surg 239:14–21.  https://doi.org/10.1097/01.sla.0000103020.19595.7d CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Mirnezami AH, Mirnezami R, Venkatasubramaniam AK et al (2010) Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery. Colorectal Dis 12:1084–1093.  https://doi.org/10.1111/j.1463-1318.2009.01999.x CrossRefPubMedGoogle Scholar
  5. 5.
    Al-Bassam A (2010) Robotic-assisted surgery in children: advantages and limitations. J Robot Surg 4:19–22.  https://doi.org/10.1007/s11701-010-0181-3 CrossRefPubMedGoogle Scholar
  6. 6.
    Hockstein NG, Gourin CG, Faust RA, Terris DJ (2007) A history of robots: from science fiction to surgical robotics. J Robot Surg 1:113–118.  https://doi.org/10.1007/s11701-007-0021-2 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    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 15:267–275.  https://doi.org/10.1053/j.sempedsurg.2006.07.006 CrossRefPubMedGoogle Scholar
  8. 8.
    Chi JJ, Mandel JE, Weinstein GS, O’Malley BW (2010) Anesthetic considerations for transoral robotic surgery. Anesthesiol Clin 28:411–422.  https://doi.org/10.1016/j.anclin.2010.07.002 CrossRefPubMedGoogle Scholar
  9. 9.
    Mariano ER, Furukawa L, Woo RK et al (2004) Anesthetic concerns for robot-assisted laparoscopy in an infant. Anesth Analg 99:1665–1667.  https://doi.org/10.1213/01.ANE.0000137394.99683.66 CrossRefPubMedGoogle Scholar
  10. 10.
    van Haasteren G, Levine S, Hayes W (2009) Pediatric robotic surgery: early assessment. Pediatrics 124:1642–1649.  https://doi.org/10.1542/peds.2008-3822 CrossRefPubMedGoogle Scholar
  11. 11.
    Gutt CN, Markus B, Kim ZG et al (2002) Early experiences of robotic surgery in children. Surg Endosc 16:1083–1086.  https://doi.org/10.1007/s00464-001-9151-1 CrossRefPubMedGoogle Scholar
  12. 12.
    Heller K, Gutt C, Schaeff B et al (2002) Use of the robot system Da Vinci for laparoscopic repair of gastro-oesophageal reflux in children. Eur J Pediatr Surg 12:239–242.  https://doi.org/10.1055/s-2002-34489 CrossRefPubMedGoogle Scholar
  13. 13.
    Meehan JJ, Sandler A (2008) Pediatric robotic surgery: a single-institutional review of the first 100 consecutive cases. Surg Endosc 22:177–182.  https://doi.org/10.1007/s00464-007-9418-2 CrossRefPubMedGoogle Scholar
  14. 14.
    Klein MD, Langenburg SE, Kabeer M et al (2007) Pediatric robotic surgery: lessons from a clinical experience. J Laparoendosc Adv Surg Tech A 17:265–271.  https://doi.org/10.1089/lap.2006.0034 CrossRefPubMedGoogle Scholar
  15. 15.
    Sinha CK, Haddad M (2008) Robot-assisted surgery in children: current status. J Robot Surg 1:243–246.  https://doi.org/10.1007/s11701-007-0054-6 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bodner J, Lucciarini P, Fish J et al (2005) Laparoscopic splenectomy with the da Vinci robot. J Laparoendosc Adv Surg Tech A 15:1–5.  https://doi.org/10.1089/lap.2005.15.1 CrossRefPubMedGoogle Scholar
  17. 17.
    Albassam AA, Mallick MS, Gado A, Shoukry M (2009) Nissen fundoplication, robotic-assisted versus laparoscopic procedure: a comparative study in children. Eur J Pediatr Surg 19:316–319.  https://doi.org/10.1055/s-0029-1220680 CrossRefPubMedGoogle Scholar
  18. 18.
    Lee JR (2014) Anesthetic considerations for robotic surgery. Korean J Anesthesiol 66:3–11.  https://doi.org/10.4097/kjae.2014.66.1.3 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Davies B (2000) A review of robotics in surgery. Proc Inst Mech Eng [H] 214:129–140.  https://doi.org/10.1243/0954411001535309 CrossRefGoogle Scholar
  20. 20.
    Alotaibi W (2009) Pediatric anesthesia at King Khalid University Hospital. J Taibah Univ Med Sci 4:156–161.  https://doi.org/10.1016/S1658-3612(09)70104-0 CrossRefGoogle Scholar
  21. 21.
    Meehan JJ, Elliott S, Sandler A (2007) The robotic approach to complex hepatobiliary anomalies in children: preliminary report. J Pediatr Surg 42:2110–2114.  https://doi.org/10.1016/j.jpedsurg.2007.08.040 CrossRefPubMedGoogle Scholar
  22. 22.
    Ostlie DJ, Miller KA, Woods RK, Holcomb GW (2003) Single cannula technique and robotic telescopic assistance in infants and children who require laparoscopic Nissen fundoplication. J Pediatr Surg 38:111–115.  https://doi.org/10.1053/jpsu.2003.50022 CrossRefPubMedGoogle Scholar
  23. 23.
    Anderberg M, Kockum CC, Arnbjörnsson E (2007) Robotic fundoplication in children. Pediatr Surg Int 23:123–127.  https://doi.org/10.1007/s00383-006-1817-2 CrossRefPubMedGoogle Scholar
  24. 24.
    Draaisma WA, Ruurda JP, Scheffer RCH et al (2006) Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Br J Surg 93:1351–1359.  https://doi.org/10.1002/bjs.5535 CrossRefPubMedGoogle Scholar
  25. 25.
    Lehnert M, Richter B, Beyer PA, Heller K (2006) A prospective study comparing operative time in conventional laparoscopic and robotically assisted Thal semifundoplication in children. J Pediatr Surg 41:1392–1396.  https://doi.org/10.1016/j.jpedsurg.2006.04.025 CrossRefPubMedGoogle Scholar
  26. 26.
    Melvin WS, Needleman BJ, Krause KR et al (2002) Computer-enhanced vs. standard laparoscopic antireflux surgery. J Gastrointest Surg 6:11–15CrossRefPubMedGoogle Scholar
  27. 27.
    Meehan JJ, Meehan TD, Sandler A (2007) Robotic fundoplication in children: resident teaching and a single institutional review of our first 50 patients. J Pediatr Surg 42:2022–2025.  https://doi.org/10.1016/j.jpedsurg.2007.08.022 CrossRefPubMedGoogle Scholar
  28. 28.
    Woo R, Le D, Albanese CT, Kim SS (2006) Robot-assisted laparoscopic resection of a type I choledochal cyst in a child. J Laparoendosc Adv Surg Tech A 16:179–183.  https://doi.org/10.1089/lap.2006.16.179 CrossRefPubMedGoogle Scholar
  29. 29.
    Muñoz CJ, Nguyen HT, Houck CS (2016) Robotic surgery and anesthesia for pediatric urologic procedures. Curr Opin Anaesthesiol 29:337–344.  https://doi.org/10.1097/ACO.0000000000000333 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Anesthesia, College of MedicineKing Saud UniversityRiyadhSaudi Arabia

Personalised recommendations