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Pediatric Robotic Surgery in Romania: Review of the First 71 Cases Using the da Vinci Platform
Vlad-Laurentiu David1,2, Maria-Corina Stanciulescu1,2, Emil-Radu Iacob1,2
1Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Insights
Robotic-assisted surgery in children is safe and effective, showing good early results and a learning curve for setup. This approach is feasible for various pediatric procedures.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Robotics
Background:
- Robotic-assisted surgery adoption in pediatrics is growing.
- Limited data exists on early implementation stages of pediatric robotic surgery.
Purpose of the Study:
- To evaluate the feasibility and outcomes of robotic-assisted surgery in pediatric patients.
- To analyze the learning curve associated with robotic surgical procedures in children.
Main Methods:
- Prospective audit of 71 pediatric robotic-assisted procedures over 24 months.
- Utilized the da Vinci Xi platform in a tertiary pediatric center.
- Analyzed patient demographics, surgical indications, perioperative data, and outcomes.
Main Results:
- 71 procedures in 71 pediatric patients (mean age 4.46 years).
- Common procedures included cholecystectomy, ovarian tumor excision, and pyeloplasty.
- Low complication rates (9.9% intraoperative, 2.8% conversion, 2.8% postoperative); no mortality.
- Significant improvement in trocar insertion and docking times over the study period.
Conclusions:
- Robotic-assisted pediatric surgery is feasible and safe.
- Acceptable complication rates and favorable early outcomes observed.
- Measurable learning curve demonstrated by improved operative setup times.
Background:
Robotic-assisted surgery has increasingly been adopted in pediatric surgical practice; however, data from early implementation stages remain limited.
Materials And Methods:
We conducted a prospective audit of the first 71 pediatric robotic-assisted procedures performed over a 24-month period using the da Vinci Xi platform in a tertiary pediatric center. Patient characteristics, surgical indications, perioperative parameters, and postoperative outcomes were analyzed.
Results:
A total of 71 procedures were performed in 71 patients (39 girls, 32 boys; mean age 4.46 years). The most frequent procedures were cholecystectomy (n = 19), ovarian tumor excision (n = 14), and pyeloplasty (n = 13). Mean operative time was 90 ± 65.30 min. Intraoperative complications occurred in 9.9% of cases, conversion to open surgery in 2.8%, and postoperative complications in 2.8%. Trocar insertion time and docking time improved significantly during the second year (p < 0.05). No mortality or long-term complications were recorded.
Conclusions:
Robotic-assisted pediatric surgery is feasible and safe, with acceptable complication rates and favorable early outcomes. Progressive improvement in operative setup parameters reflects a measurable learning curve.
