Robotic Assisted Endoscopic Surgery Practices in Pediatric Surgery, Single Center Experience

Abstract

Objective: While robot-assisted laparoscopic surgery (RALS) is spreading rapidly all over the world, In pediatric surgery, this spread is slower than in adult surgery for many reasons. In this study, we discuss our initial experiences with pediatric robotic surgical cases. Material and Methods: Robotic-assisted endoscopic surgery between November 2017 and April 2022 was retrospectively reviewed. The medical records of the patients were reviewed retrospectively for some demographical features, surgical details, and follow-up time. Results: Of the 48 children, 27 were male and 21 were female. The youngest of the cases was 10 months old, while the oldest was 17 years old (mean 7.72±5.6, median 7). The shortest follow-up period after surgery was 5 months, while the longest follow-up was 60 months. A total of 63 surgical procedures were performed on 48 pediatric patients. 17 pyeloplasty (left 10, right 7), 9 Lich Gregoir operations (right 6, left 3), 4 ureteral reimplantation and tapering procedures due to left ureterovesical junction obstruction (UJO), 3 Hemi nephrectomy, one appendicovesicostomy, One right ureteral reimplantation, 11 Nissen fundoplication, 10 gastrostomy and one gastrojejunostomy, two ovarian sparing surgeries for ovarian cyst were performed. One urachal remnant excision, one adrenal mass excision, and one thoracic outlet mass excision were performed. Conclusion: This is the first study that includes a wide range of pediatric robotic surgical procedures in our country. Robotic-assisted laparoscopic procedures in pediatric surgery can be safely performed for many surgical pathologies. We think at the beginning some simple surgical procedures and then turning to the more complex procedures after at least 15 cases will be more appropriate.