Robot-assisted Minimally Invasive Thoracic Surgery in Children: “Experience and Current Scenario”

The goal of this chapter is to provide our experience with robotic-assisted minimally invasive thoracic surgery (MITS) in children. In addition, a current scenario analysis is conducted on this topic.

From March 2015 to April 2019, observational, prospective, and longitudinal studies were conducted on children with thoracic pathology treated with robotic surgery. The “Da Vinci surgical system” was employed (Intuitive Surgical, Inc., Sunnyvale, CA. USA). Demographic information, diagnosis, surgery, console surgery time, bleeding, hemotransfusions, conversions, complications, postoperative (PO) stay, and follow-up were all recorded factors. The researchers used central tendency measures. The study was authorised by the Hospital’s Research Ethics Committee. We did a non-systematic evaluation of existing articles of children who had thoracic robotic surgery.

We treated 11 youngsters, who were on average 5.7 years old and weighed 21.3 kg. Congenital cystic adenomatoid malformation, intralobar sequestration, diaphragmatic paralysis, diaphragmatic eventration, mediastinal teratoma, Ewing’s tumour of the fourth left rib, and pulmonary tuberculosis were all identified as diagnoses. Four lobectomies, four diaphragmatic plications, two tumour resections, and one case of pleural and lung biopsies were performed. The average duration for console operation was 166.45 minutes, the usual PO stay was 3.6 days, and the average follow-up was 24.7 months. There were 9.1% conversions and PO problems, but no intraoperative complications or mortality. The number of published paediatric cases treated using robot-assisted thoracic surgery (RATS) is currently hovering around 170.

Conclusion: Our findings seem promising, despite the fact that our expertise is restricted to a few cases. The use of robotic surgery to treat paediatric thoracic disease is practical, safe, and beneficial. To date, just a few patients have been treated, and only a few paediatric surgeons have used thoracic robotic surgery in children around the world.

In the future, further miniaturisation of technology will be required to treat youngsters with less weight, which is currently a restriction. In the future years, more robotic systems will hit the market, with wrist instruments with a diameter of 5mm or less.

Robotic surgery using minirobots that conduct surgical tasks via remote control may appear to be science fiction, but the future of true minimally invasive surgery (MIS) is yet ahead of us.

Author (S) Details

Mario Navarrete-Arellano

Department of Pediatric Surgery, Hospital Central Militar, SEDENA, Mexico City 11200, Mexico and Hospital Angeles Lomas, Vialidad de la Barranca 240, Hacienda de las Palmas, Huixquilucan, 52763, Estado de Mexico, Mexico.

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