REVIEW  NEW TRENDS IN PEDIATRIC SURGERY 

Minerva Pediatrica 2018 June;70(3):308-14

DOI: 10.23736/S0026-4946.18.05113-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Current perspectives in robot-assisted surgery

Aurélien BINET ¹, Quentin BALLOUHEY ², Yann CHAUSSY ³, Guénolée de LAMBERT ¹, Karim BRAÏK ¹, Thierry VILLEMAGNE ¹, François BECMEUR ⁴, Laurent FOURCADE ², Hubert LARDY ¹ ✉

¹ Service of Pediatric Visceral Surgery, Clocheville Hospital, Tours, France; ² Service of Pediatric Visceral Surgery, Children’s Hospital, Limoges, France; ³ Service de Pediatric Visceral Surgery, Jean Minjoz Hospital, Besançon, France; ⁴ Service of Pediatric Visceral Surgery, Hautepierre Hospital, Strasbourg, France

From classical surgery to robot-assisted surgery (RAS), there has been a long way allowed by the improvements achieved in minimally invasive surgery (MIS). The last three decades have witnessed a prodigious development of MIS, and especially in the field of laparoscopic pediatric surgery but there are several limitations in the use of conventional laparoscopic surgery and RAS was developed to relieve these drawbacks. This new technology enables today the performance of a wide variety of procedures in children with a minimally invasive approach. As for all new technologies, an objective evaluation is essential with the need to respond to several questions: is the technology feasible?, is the technology safe?, is the technology efficient?, does it bring about benefits compared with current technology?, what are the procedures derived from most benefits of robotic assistance?, how to assume the transition from open surgery to minimally invasive access for RAS? In the first part of this article, some details are provided about technical concerns. Then, the implementation process with its organization, pitfalls, successes, and issues from human resources and financial standpoints is described. The learning curve is also analyzed, and a special focus on small children weighing less than 15 kg is developed. Finally, the concept of evaluation of this emerging technology is evocated and financial concerns are developed.

KEY WORDS: Robotic surgical procedures - Minimally invasive surgical procedures - Pediatrics