Robot-assisted surgery for pediatric tumors: A single-center study of 114 cases

Although robot-assisted surgery has been widely adopted for adult malignancies, its application in pediatric oncology remains contentious because of limited evidence. This study aims to assess the safety, feasibility, and surgical indications of robot-assisted surgery in pediatric oncology.

A retrospective analysis was conducted on pediatric patients who underwent robot-assisted surgery at the Department of Surgical Oncology, Beijing Children's Hospital, between June 2021 and January 2024.

Overall, 114 children (64 female) were treated with robot-assisted surgery, including 2 children who underwent both robot-assisted thoracoscopic surgery and laparoscopic surgery at the same time. Of these, neuroblastic tumors (49, 42.98%) account for the most, followed by the germ cell tumor (33, 28.95%). The remaining 32 tumors included pancreatic (n = 2), renal (n = 2; 1 case of renal clear cell sarcoma, 1 case of renal carcinoma), hepatoblastoma (n = 3), hepatocellular carcinoma (n = 1), and other different rare tumors (n = 24). No intraoperative tumor rupture occurred. Additionally, 2 children with stage 4S neuroblastoma underwent concurrent biopsy of liver metastases. The median hospital stay was 6 days (4-7), and the postoperative complication rate was 2.63%.

Robot-assisted surgery is a safe and feasible approach for pediatric tumors, offering reduced surgical trauma and faster postoperative recovery. With adequate surgical expertise, robot-assisted surgery can achieve oncologic outcomes comparable to open surgery, making it a promising alternative for selected pediatric patients.