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The first decade of robotic surgery in children
Thomas P Cundy1, Kunal Shetty, James Clark
1The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, United Kingdom. t.cundy@imperial.ac.uk
Insights
Robotic surgery is expanding in pediatric procedures, with increasing case volumes and publications. Continued evaluation alongside clinical adoption is recommended for evidence-based practice.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery Technology
Background:
- Robotic surgery addresses challenges in pediatric minimally invasive surgery, especially in confined pediatric operative spaces.
- The first robotic procedure in a child was performed in April 2001.
- This review covers the initial decade of robotic surgery in pediatric patients.
Purpose of the Study:
- To examine global case volumes, trends, and evidence quality for pediatric robotic surgery.
- To analyze the adoption and diffusion of robotic surgical techniques in children.
Main Methods:
- Systematic literature search from April 2001 to March 2012.
- Inclusion of all reported robotic surgery cases in pediatric patients.
- Analysis of publication trends and case volumes.
Main Results:
- 137 articles reported 2393 procedures in 1840 pediatric patients.
- Common procedures included fundoplication (gastrointestinal), pyeloplasty (genitourinary), and lobectomy (thoracic).
- Increasing publications and case volumes were observed, with a 2.5% conversion rate and 0.5% malfunction rate.
Conclusions:
- Robotic surgery is a growing innovation in pediatric surgery.
- Simultaneous evolution and evaluation are crucial for clinical adoption.
- Higher quality evidence should guide future practice.
Background:
Robotic surgery offers technological solutions to current challenges of minimal access surgery, particularly for delicate and dexterous procedures within spatially constrained operative workspaces in children. The first robotic surgical procedure in a child was reported in April 2001. This review aims to examine the literature for global case volumes, trends, and quality of evidence for the first decade of robotic surgery in children.
Methods:
A systematic literature search was performed for all reported cases of robotic surgery in children during the period of April 2001 to March 2012.
Results:
Following identification of 220 relevant articles, 137 articles were included, reporting 2393 procedures in 1840 patients. The most prevalent gastrointestinal, genitourinary, and thoracic procedures were fundoplication, pyeloplasty, and lobectomy, respectively. There was a progressive trend of increasing number of publications and case volumes over time. The net overall reported conversion rate was 2.5%. The rate of reported robot malfunctions or failures was 0.5%.
Conclusions:
Robotic surgery is an expanding and diffusing innovation in pediatric surgery. Future evolution and evaluation should occur simultaneously, such that wider clinical uptake may be led by higher quality and level of evidence literature.