A review of robotic-assisted mediastinal surgery in the pediatric population

Advances in minimally invasive surgical techniques have greatly decreased the morbidity associated with large open thoracic operations. Robotic-assisted thoracic surgery is at the forefront of minimally invasive techniques and has been rapidly adopted in the adult population. However, the integration of robotic surgery in the pediatric population has been slower. Mediastinal resections are particularly well suited for a robotic approach as it offers precise motor control and dexterity within a confined space. The objective of this study is to clarify the feasibility and safety of a robotic approach to pediatric mediastinal pathology. We queried the online databases of PubMed, Web of Science, and Embase to identify studies and case reports regarding robotic-assisted mediastinal surgery in the pediatric population, defined as patients less than 18 years old. A total of 12 studies and case reports were utilized to synthesize a review of robotic-assisted mediastinal surgery in the pediatric population. While the available literature regarding the topic of pediatric robotic-assisted mediastinal surgery is sparse, the studies and case reports that do exist suggest that robotic-assisted mediastinal surgery within this population is both feasible and safe. The available literature identified in this review demonstrates low complication rates and low rates of conversion to open surgery speaking to the safety and feasibility of this approach. This review also suggests that a robotic approach offers superior flexibility, improved visualization, improved ergonomics and better alignment of hand motion when compared to traditional video-assisted thoracic surgery (VATS).