Use of the robot system DaVinci for laparoscopic repair of gastroesophageal reflux in children

Abstract

In adult patients, laparoscopic surgery, using a robot system (Da Vinci, Intuitive Surgical, Mountain View, CA), has been recently introduced into surgical practice. To investigate the feasibility of the system in pediatric surgery, laparoscopic fundoplications as well as cholecystectomies have been performed. In July 2000, the authors used the robot system for the first time in an 11-year-old girl with gastroesophageal reflux, and since that time on 7 other children. Altogether, 5 Thal and 3 Nissen procedures have been carried out. All operations were performed without complications and without conversion to open surgery. The average operating time was 146 min with a range of 103 to 180 minutes. Compared with conventional surgery, the 3-dimensional high-quality vision, the advanced instrument movements, and the ergonomic position of the surgeon seems to enhance surgical precision. It is, therefore, concluded that the use of the robot system is feasible and safe in pediatric surgery. The technique is limited because of the fact that instruments adapted to pediatric size are not yet available.—Thomas A. Angerpointner