Related Experiment Video
Updated: Jan 10, 2026
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Robotic-assisted surgery in children under 10 kg: a systematic review
Carlos Delgado-Miguel1,2, Juan Camps3, Isabella Garavis Montagut4
1Department of Pediatric Surgery, Fundación Jiménez Díaz University Hospital, Avenida de los Reyes Católicos, 2, 28040, Madrid, Spain. carlosdelgado84@hotmail.com.
Insights
Robotic surgery is safe and effective for children under 10 kg, with diverse applications in gastrointestinal, hepatobiliary, colorectal, and urological procedures. This systematic review highlights low complication rates, supporting its use in pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic surgery adoption in pediatric patients is increasing.
- Procedures are being performed on younger and smaller children.
- Surgical indications are expanding for neonates and infants.
Purpose of the Study:
- To systematically review robotic-assisted surgery in pediatric patients weighing under 10 kg.
- To evaluate the safety and efficacy of robotic surgery in this population.
- To identify common surgical indications and outcomes.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched PubMed, CINAHL, Web of Science, and EMBASE.
- Included studies on pediatric patients under 10 kg, with data extraction on demographics, indications, and outcomes.
Main Results:
- 37 articles with 1,437 pediatric patients under 10 kg were included.
- Indications spanned congenital diaphragmatic anomalies, GI, hepatobiliary, colorectal, and urological procedures.
- Reported postoperative complications were 9.6%, with 1.1% conversions.
Conclusions:
- Robotic surgery is a safe and effective approach for pediatric patients under 10 kg.
- Multiple surgical indications exist, including thoracic, GI, hepatobiliary, colorectal, and urological procedures.
- Low conversion and complication rates were observed, though prospective studies are needed.
Introduction:
Robotic surgery has been progressively adopted in pediatric patients over recent years, accompanied by a reduction in the age and weight of those treated, as well as an expansion of surgical indications in increasingly smaller children.
Methods:
A systematic review was conducted in accordance with PRISMA guidelines, searching PubMed, CINAHL, Web of Science and EMBASE for studies on robotic-assisted surgery in children weighing under 10 kg, registered in PROSPERO (CRD420251110421). Two reviewers independently screened all records against predefined inclusion criteria. Extracted data included study design, patient demographics, surgical indications, intraoperative variables, and perioperative outcomes.
Results:
A total of 37 articles, comprising 1,437 pediatric patients under 10 kg and published between 2007 and 2025, met the inclusion criteria for narrative synthesis in our systematic review. Of these, 18 (48.6%) were retrospective descriptive analyses, 14 (37.8%) were retrospective comparative studies, and 5 (13.5%) were case reports. Robotic surgery indications were grouped into five categories: congenital diaphragmatic anomalies, addressed in two studies (5.4%); gastrointestinal disorders, reported in eight studies (21.6%); hepatobiliary procedures-including biliary atresia and choledochal cyst excision-featured in eleven studies (29.7%); colorectal procedures, such as anorectal malformations and Hirschsprung's disease, reported in seven studies (18.9%); and urological procedures, described in nine studies (24.3%). A total of 89 postoperative complications (9.6%) and 10 conversions (1.1%) were reported.
Conclusions:
Robotic surgery in patients weighing less than 10 kg has multiple indications, including thoracic, gastrointestinal, hepatobiliary, colorectal, and urological procedures. It seems to be a safe and effective approach in this population, with low conversion and postoperative complication rates. The lack of comparative and prospective studies, along with the heterogeneity of procedures, are the main limitations.
