Da Vinci Robotic Surgery in a Pediatric Hospital

Girolamo Mattioli, Alessio Pini Prato, Barbara Razore, Lorenzo Leonelli, Luca Pio, Stefano Avanzini, Alessandro Boscarelli, Paola Barabino, Nicola Massimo Disma, Clelia Zanaboni, Alfredo Garzi, Sofia Paola Martigli, Ubaldo Rosati, Paolo Petralia

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Abstract

INTRODUCTION: Since the use of robotic surgery (RS) revolutionized some adult surgery procedures such as radical prostatectomy, it has been progressively and increasingly introduced in pediatric surgery. The aim of this study is to evaluate how the Da Vinci® Si HD technology impacts a pediatric public hospital and to define the use of a robotic system in pediatric surgery.

MATERIALS AND METHODS: We prospectively included patients older than 6 months of age undergoing RS or conventional minimal access surgery (MAS): Study period ranges between February 2015 and April 2016. Surgical indications were defined after a detailed disease-specific diagnostic work-up. We analyzed surgical outcomes and the most relevant economic aspects. The 30-day postoperative complications were evaluated and retrospectively collected in an electronic database.

RESULTS: From February 2015 to April 2016, we performed 77 procedures with RS and 84 with conventional MAS in patients with a median age of 77 and 98 months at surgery and a median weight of 20 and 23 kg, respectively. Median operative times were 130 and 109 minutes, respectively. We observed 9.1% of complications in the RS group and 6% in the MAS group and the difference was not statistically significant. Of note, 8 out of 77 RS procedures would have been performed with open classic surgery in case of conversion or failure of RS.

CONCLUSIONS: This initial experience confirms that RS is as safe and effective as conventional MAS. A number of selected procedures performed with RS would only benefit from this approach, as it is not suitable for conventional MAS. Although economically demanding, in particular for a pediatric hospital, we firmly believe that centralization of care would allow pediatric surgeons adopting RS to perform complex reconstructive surgical procedures with great advantages for the patients and a minimal increase in overall costs for the health system.

Original languageEnglish
Pages (from-to)539-545
Number of pages7
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume27
Issue number5
DOIs
Publication statusPublished - May 2017

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Keywords

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Hospitals, Pediatric
  • Hospitals, Public
  • Humans
  • Infant
  • Male
  • Minimally Invasive Surgical Procedures
  • Operative Time
  • Postoperative Complications
  • Retrospective Studies
  • Robotic Surgical Procedures
  • Young Adult
  • Journal Article

Cite this

Mattioli, G., Pini Prato, A., Razore, B., Leonelli, L., Pio, L., Avanzini, S., Boscarelli, A., Barabino, P., Disma, N. M., Zanaboni, C., Garzi, A., Martigli, S. P., Rosati, U., & Petralia, P. (2017). Da Vinci Robotic Surgery in a Pediatric Hospital. Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A, 27(5), 539-545. https://doi.org/10.1089/lap.2016.0390