The use of robotic single site system in pediatric surgery: a systematic review

Robotic surgery represents a groundbreaking advancement in modern surgery, offering precision, enhanced visualization, and reduced invasiveness. Robotic single-site surgery (RSSS), utilizing a single incision for access, combines these benefits with improved cosmetic outcomes, making it particularly appealing for pediatric patients. This systematic review evaluates the feasibility, clinical outcomes, and procedural details of RSSS in children.A systematic review was conducted using PRISMA guidelines, with searches across PubMed, Web of Science, Scopus, Medline, and Cochrane Library up to June 2024. Studies reporting on RSSS in pediatric patients were included, focusing on demographics, surgical details and outcomes such as conversion rate, blood loss, complications, reoperations, and hospital stay. Data extraction and quality assessment were independently conducted by reviewers using the Newcastle-Ottawa Scale.Seventeen studies with 322 pediatric patients were included. Procedures performed included cholecystectomy (54.7%), pyeloplasty (23.6%), choledochal cyst resection (7.4%), ureteral reimplantation (7.8%), and inguinal hernia repair (6.5%). The overall complication rate was 6% (minor complications, Clavien-Madadi grade I), with a conversion rate of 0.3% and no reoperations reported. Mean operative times varied by procedure, with minimal blood loss and short hospital stays.RSSS is a feasible and safe technique in pediatric surgery, demonstrating low complication and conversion rates. While it offers significant benefits in precision and cosmetic outcomes, further research is essential to optimize its application in pediatric surgical practice.