Complex Pediatric Robotic Surgery: A Single-institution’s Experience

Purpose: For advanced laparoscopists, the greatest benefit of robotic surgical technology is in its use for complex procedures, ones that require significant dexterity in limited workspace and are challenging with conventional instrumentation. We present our 3-year institutional experience using robotic-assisted laparoscopic surgery for complex pediatric surgical procedures. Methods: Retrospective review from 2003 to 2006 of all complex cases performed by 2 advanced laparoscopic pediatric surgeons using the da Vinci surgical robot. Data reviewed included patient age, procedure type, total operative time, outcome, and complications. Results: Five operations were performed including Kasai portoenterosotomy (2), choledochal cyst excision (1), Ladd’s procedure (1), posterior mediastinal mass resection (1) and subcutaneous resection of giant lipoma (1). Post-operative complications were limited to a prolonged ileus in the patient undergoing Ladd’s procedure. All remaining patients had an uneventful recovery. Table below depicts procedure type, patient age and weight and operative times (including anesthetic induction, robot draping, docking, and surgical procedure).
Conclusions: Robotic technology can be used to perform complex abdominal and thoracic operations in children. Three-dimensional high quality optics, articulated instruments, and tremor filtration enable complex, subtle tasks such as suturing in a limited workspace or fine dissection. Robot setup and operative times are initially long and subject to a learning curve.

Session: Poster

Program Number: P392

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