Abstract
Aim: We report our experience in minimally invasive thoracic robot-assisted surgery in children, and a current analysis is carried out on this topic. Methods: Observational, prospective, and longitudinal studies were performed for children with thoracic pathology treated with robotic surgery, from March 2015 to April 2019. We used the “da Vinci surgical system” (Intuitive Surgical, Inc., Sunnyvale, CA. USA). Registered variables included demographic data, diagnosis, surgery, total time, time of console surgery, bleeding, hemotransfusions, conversions, complications, postoperative (PO) stay, and follow-up. Measures of central tendency were used. Research Ethics Committee of Hospital approved the study. We conducted a detailed non-systematic review of previous publications of children undergoing thoracic robotic surgery. Results: We treated 11 children, with average age of 5.7 years and weight of 21.3 kg. Diagnosis were: congenital cystic adenomatoid malformation, intralobar sequestration, diaphragmatic paralysis, diaphragmatic eventration, mediastinal teratoma, Ewing’s tumor of the fourth left rib, and pulmonary tuberculosis. Surgeries performed were: four lobectomies, four diaphragmatic plications, two tumor resections, and a case of pleural and lung biopsies. The average of console surgery time was 166.45 min, PO stay was 3.6 days, and follow-up was 24.7 months. Conversions and PO complications were 9.1%, and there were no intraoperative complications and mortality. Currently, the number of children treated with thoracic robot-assisted surgery has barely reached 100 cases. Conclusion: Our results are encouraging, although our experience is limited to a few cases. Robotic surgery for the treatment of thoracic pathology is feasible and safe, and has advantages. To date, very few patients have been treated, and few pediatric surgeons worldwide have applied thoracic robotic surgery in children.
Highlights
Invasive techniques are applicable in more than 60% of abdominal and thoracic operations in children, according to evidence-based data and ethical principles can be used properly[1]
Our results are encouraging, our experience is limited to a few cases
The global experience in thoracoscopic surgery in children is more than 30 years compared to robotassisted thoracic surgery (RATS), and, the learning curve for thoracoscopy is longer compared to RATS, there are centers in the world where this curve has been overcome
Summary
Invasive techniques are applicable in more than 60% of abdominal and thoracic operations in children, according to evidence-based data and ethical principles can be used properly[1]. The first publication on thoracoscopy in children dates from 1971 in Russia and, fundamentally its application at that time was diagnosed in thoracic diseases and neoplasms[2]. From that date to the present, thoracoscopic surgery in children has been applied in a wide range of thoracic pathologies, with diagnostic and therapeutic procedures. The global experience in thoracoscopic surgery in children is more than 30 years compared to robotassisted thoracic surgery (RATS), and, the learning curve for thoracoscopy is longer compared to RATS, there are centers in the world where this curve has been overcome. In 1981, Rodgers reported 80 thoracoscopic procedures in children, which were performed without mortality and with minimal morbidity, and the main technique was lung biopsy[4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
