Conversions in pediatric robot-assisted laparoscopic surgery.

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Concerns regarding the safety and effectiveness of new surgical technologies, particularly conversion rates in pediatric robot-assisted surgery.
• Analysis of an 11-year experience with conversions from a dedicated pediatric robot-assisted laparoscopic surgery service.

Purpose of the Study:

• To analyze the frequency and circumstances of conversions in pediatric robot-assisted surgery.
• To evaluate the safety and effectiveness of robotic technology in pediatric advanced laparoscopy.

Main Methods:

• Prospective database evaluation of consecutive pediatric patients undergoing robot-assisted surgery from March 2006 to May 2017.
• Descriptive and quantitative analysis of conversion data, including patient age, procedure type, and surgeon experience.

Main Results:

• A total of 601 procedures were performed on 539 children, with 31 conversions (5.8%).
• Conversion rates were higher in younger children (10.0% for 0-2 years) and varied significantly by procedure type.
• Anesthetic-related issues (52%) were the most common reason for conversion; no conversions were due to intraoperative complications.

Conclusions:

• Robot-assisted surgery in children demonstrates low conversion rates, even during the learning phase.
• These rates are favorable when compared to conventional laparoscopy, supporting the safety and efficacy of robotic assistance for advanced pediatric laparoscopic procedures.
• Optimization of surgical conditions is crucial for minimizing conversions.