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Small population sizes put a species at extreme risk of extinction due to a lack of variation, and a consequent decrease in adaptability. This weakens the chances of survival under pressures such as climate change, competition from other species, or new diseases. Large populations are more likely to survive pressures such as these, as such populations are more likely to harbor individuals that have genetic variants that are adaptive under new stresses. Small populations are much less...
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Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture
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Robotic Neck Surgery in the Pediatric Population.

Eric L Wu1, Meghan E Garstka1, Sang-Wook Kang1

  • 1Division of Endocrine and Oncological Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|October 3, 2018
PubMed
Summary

Robot-assisted neck surgery using transaxillary and retroauricular approaches is safe and feasible in select pediatric patients. These minimally invasive techniques offer a viable alternative to traditional cervical surgery for thyroid, parathyroid, and thymus procedures.

Keywords:
Pediatric neck surgeryRetroauricular approachRobotic pediatric surgeryRobotic surgeryTransaxillary approach

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Area of Science:

  • Pediatric Surgery
  • Robotic Surgery
  • Head and Neck Surgery

Background:

  • Traditional cervical approaches for thyroid, parathyroid, and thymus surgeries carry inherent risks.
  • Robot-assisted surgery presents a potentially safer alternative for pediatric neck operations.

Purpose of the Study:

  • To evaluate the feasibility and safety of robotic transaxillary and retroauricular approaches in pediatric neck surgery.
  • To report surgical outcomes including operative time, complications, and hospital stay.

Main Methods:

  • Retrospective review of pediatric patients undergoing robot-assisted neck surgery by a single surgeon (April 2010 - May 2017).
  • Analysis of patient demographics, surgical procedures (thyroidectomy, parathyroidectomy, thymectomy, cyst excision), and outcomes.
  • Comparison of operative times between retroauricular and transaxillary robotic approaches.

Main Results:

  • Nine surgeries were performed in 7 female pediatric patients (mean age 16.0 years).
  • No conversions, permanent vocal cord paralysis, permanent hypoparathyroidism, hematoma, or seroma were reported.
  • Temporary shoulder hypoesthesia (11%) and vocal cord paresis (22%) were the main complications.

Conclusions:

  • Robotic transaxillary and retroauricular approaches are feasible and safe for select pediatric neck surgeries.
  • These minimally invasive techniques can be successfully employed by high-volume surgeons.
  • Robot-assisted surgery offers a valuable alternative to conventional methods for pediatric head and neck procedures.