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Advancing Pediatric Robotic Colorectal Surgery: Trends, Outcomes, and Future Directions-A Comprehensive Review
Alessio Pini Prato1, Martin Lacher2
1Department of Mother and Child Health, Unit of Pediatric Surgery, The Children Hospital, Umberto Bosio Center for Digestive Diseases, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Insights
Pediatric robotic colorectal surgery is safe and effective for conditions like Hirschsprung disease (HSCR). While adoption faces cost and training hurdles, technological advancements promise wider use and better outcomes in pediatric surgery.
Area of Science:
- Minimally Invasive Surgery
- Pediatric Surgery
- Surgical Technology
Background:
- Pediatric robotic colorectal surgery offers enhanced precision and safety for complex conditions including Hirschsprung disease (HSCR), anorectal malformations (ARMs), and inflammatory bowel disease (IBD).
- This review examines current trends, outcomes, and complications in robotic colorectal procedures for pediatric patients.
Purpose of the Study:
- To analyze recent trends, outcomes, and complications of robotic colorectal surgery in pediatric patients.
- To assess the safety and efficacy of robotic colorectal procedures for conditions like HSCR, ARMs, and IBDs.
Main Methods:
- A systematic review of PubMed was conducted, identifying 1,112 articles on pediatric robotic colorectal surgery.
- 35 relevant papers were analyzed, focusing on patient demographics, surgical procedures, and clinical outcomes after applying exclusion criteria.
Main Results:
- Approximately 700 pediatric patients have undergone robotic colorectal procedures since 2001, with HSCR being the most frequent indication (n=421).
- The safety profile is favorable, with 1.7% experiencing Clavien-Dindo grade III complications and 11.5% experiencing grade I-II complications.
- Robotic platforms enhance precision in dissections and reduce damage to adjacent structures, especially in complex pelvic surgeries.
Conclusions:
- Robotic colorectal surgery is a safe and effective option for pediatric patients with complex conditions such as HSCR, IBDs, and ARMs.
- Limited adoption is attributed to cost and specialized training requirements, but technological advancements are expected to increase its application.
- Ongoing improvements in robotic technology and surgical techniques will likely expand its use and enhance outcomes in pediatric colorectal surgery.
Introduction:
Pediatric robotic colorectal surgery has rapidly evolved, offering enhanced precision and safety for treating complex conditions such as Hirschsprung disease (HSCR), anorectal malformations (ARMs), and inflammatory bowel disease (IBD). This review analyzes recent trends, outcomes, and complications in robotic colorectal procedures for pediatric patients.
Materials And Methods:
A systematic review was performed using PubMed, yielding 1,112 articles related to pediatric robotic colorectal surgery. After applying exclusion criteria, 35 papers were analyzed, focusing on patient characteristics, procedure types, and clinical outcomes.
Results:
Since 2001, approximately 700 pediatric patients have undergone robotic colorectal procedures, with HSCR being the most commonly treated condition (n = 421). The review highlights that 1.7% of patients experienced Clavien-Dindo grade III complications, while 11.5% had grade I to II complications, indicating a favorable safety profile. The use of robotic platforms facilitated improved precision during perirectal dissection and reduced the risk of damage to adjacent structures, particularly in cases requiring complex pelvic dissections. Despite promising outcomes, the uptake of robotic colorectal surgery remains lower than that for urologic procedures due to challenges such as cost, instrument size, and specialized training.
Conclusion:
Robotic colorectal surgery in children is a safe and effective approach, particularly for complex conditions like HSCR, IBDs, and ARMs. While adoption is currently limited by cost and training requirements, ongoing advancements in technology and techniques promise to broaden its application and improve outcomes in pediatric surgery.
