Pediatric Robotic Surgery in South America: Advantages and Difficulties in Program Implementation.

Juan M Moldes,Roberto Luis Vagni,Virginia Tuchbaum,Pedro Mercado,Marcos G Machado,Pedro José López,Francisco Ignacio De Badiola

doi:10.3389/fped.2019.00094

Abstract

Robotic assisted laparoscopic surgery is gaining popularity around the world due to its vast benefits. Although it has been established mainly in developed countries, in South America the robotic programs have become more popular, but its growth is clearly slower. Information about robotic pediatric surgery program in Brazil, Chile, Uruguay, and Argentina was collected through e-mail surveys. Results were analyzed and compared to worldwide information about robotic surgery. Due to the wide social, economical, and technological gap between hospitals in South America, it is hard to develop a proper pediatric robotic surgery program. The main obstacles in those four countries appear to be a combination of high purchase costs and equipment maintenance, lack of financial coverage of the procedure by insurance companies and the absence of significant benefits proved in pediatrics in relation to laparoscopic surgery. The pediatric specialties are in the process of making and implementing robotic programs supported by the evident development in adult specialties. However, pediatric robotic surgery in Brazil, Chile, Uruguay and Argentina do not seems to share that growth.

Highlights

Robotic assisted surgery is one of the most advanced forms of Minimally Invasive Surgery
Our objective is to describe the current situation of robotic pediatric surgery in four countries of South America, describing the limitations and difficulties that have been faced on the implementation of a long term pediatric robotic program
Information about robotic pediatric surgery program were collected in Brazil, Chile, Uruguay, and Argentina

Summary

Introduction

Robotic assisted surgery is one of the most advanced forms of Minimally Invasive Surgery. It has been used worldwide on a broad range of medical specialties since the 1990s, evolving rapidly evolved since [1]. The relatively high incidence of ureteropelvic junction obstruction combined with surgeon familiarity with laparoscopic pyeloplasty made it a natural first robotic procedure. Since it has become more commonly performed accounting for 11–12.6% of pyeloplasties performed in the USA by 2009 [4], and it accounts for about 40% of cases nowadays [5,6,7]

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