Öz
Objective: While robot-assisted laparoscopic surgery (RALS) is spreading rapidly all over the world, In pediatric surgery,
this spread is slower than in adult surgery for many reasons. In this study, we discuss our initial experiences with
pediatric robotic surgical cases.
Material and Methods: Robotic-assisted endoscopic surgery between November 2017 and April 2022 was
retrospectively reviewed. The medical records of the patients were reviewed retrospectively for some demographical
features, surgical details, and follow-up time.
Results: Of the 48 children, 27 were male and 21 were female. The youngest of the cases was 10 months old,
while the oldest was 17 years old (mean 7.72±5.6, median 7). The shortest follow-up period after surgery was 5
months, while the longest follow-up was 60 months. A total of 63 surgical procedures were performed on 48 pediatric
patients. 17 pyeloplasty (left 10, right 7), 9 Lich Gregoir operations (right 6, left 3), 4 ureteral reimplantation and tapering
procedures due to left ureterovesical junction obstruction (UJO), 3 Hemi nephrectomy, one appendicovesicostomy, One
right ureteral reimplantation, 11 Nissen fundoplication, 10 gastrostomy and one gastrojejunostomy, two ovarian sparing
surgeries for ovarian cyst were performed. One urachal remnant excision, one adrenal mass excision, and one thoracic
outlet mass excision were performed.
Conclusion: This is the first study that includes a wide range of pediatric robotic surgical procedures in our country.
Robotic-assisted laparoscopic procedures in pediatric surgery can be safely performed for many surgical pathologies. We
think at the beginning some simple surgical procedures and then turning to the more complex procedures after at least
15 cases will be more appropriate.
Anahtar Kelimeler
Teşekkür
We thank Serhan Koç and Yasin Özhan for their support in all cases.
Kaynakça
- Salö M, Bonnor L, Graneli C, Stenström P, Anderberg M. Ten years of paediatric robotic surgery: Lessons learned. Int J Med Robot Comput Assist Surg (Internet) 2022 (cited 2022 Jul 6);(February). Available from: https://pubmed.ncbi.nlm.nih.gov/35240727/
- Arellano MN, González FG. Robot-assisted laparoscopic and thoracoscopic surgery: Prospective series of 186 pediatric surgeries. Front Pediatr 2019;7:1–9.
- Fuchs ME, DaJusta DG. Robotics in pediatric urology. Int Braz J Urol 2020;46:322–7.
- Meehan JJ, Meehan TD, Sandler A. Robotic fundoplication in children: resident teaching and a single institutional review of our first 50 patients. J Pediatr Surg 2007;42:2022–5.
- Silay MS, Spinoit AF, Undre S, Fiala V, Tandogdu Z, Garmanova T, et al. Global minimally invasive pyeloplasty study in children: Results from the Pediatric Urology Expert Group of the European Association of Urology Young Academic Urologists working party. J Pediatr Urol (Internet) 2016;12:229.e1-229.e7.
- Andolfi C, Kumar R, Boysen WR, Gundeti MS. Current Status of Robotic Surgery in Pediatric Urology. J Laparoendosc Adv Surg Tech A 2019;29:159-66.
- Lorincz A, Langenburg S, Klein MD. Robotics and the pediatric surgeon. Curr Opin Pediatr (Internet) 2003;15:262–6.
- Bansal D, Cost NG, DeFoor WR, Reddy PP, Minevich EA, Vanderbrink BA, et al. Infant robotic pyeloplasty: Comparison with an open cohort. J Pediatr Urol 2014;10:380–5.
- Cundy TP, Harling L, Hughes-Hallett A, Mayer EK, Najmaldin AS, Athanasiou T, et al. Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children. BJU Int (Internet) 2014;114:582–94.
- Finkelstein JB, Van Batavia JP, Casale P. Is outpatient robotic pyeloplasty feasible? J Robot Surg (Internet) 2016;10:233–7.
- Grimsby GM, Dwyer ME, Jacobs MA, Ost MC, Schneck FX, Cannon GM, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol (Internet) 2015;193(5 Suppl):1791–5.
- Gutt CN, Markus B, Kim ZG, Meininger D, Brinkmann L, Heller K. Early experiences of robotic surgery in children. Surg Endosc (Internet) 2002;16:1083–6.
- O’Kelly F, Farhat WA, Koyle MA. Cost, training and simulation models for robotic-assisted surgery in pediatric urology. World J Urol 2020;38:1875-82.
Öz
Giriş: Robot yardımlı laparoskopik cerrahi (RALS) tüm dünyada hızla yayılırken, pediatrik cerrahide bu yayılım birçok nedenden dolayı erişkin cerrahisine göre daha yavaştır. Bu çalışmada pediatrik robotik cerrahi olguları ile ilgili ilk deneyimlerimizi tartıştık.
Hastalar ve Yöntem: Kasım 2017-Nisan 2022 tarihleri arasındaki robotik yardımlı endoskopik cerrahi vakaları retrospektif olarak incelendi. Hastaların tıbbi kayıtları, demografik özellikleri, cerrahi kayıtları ve takip süreleri retrospektif olarak incelendi.
Bulgular: 48 çocuğun 27'si erkek, 21'i kızdı. Olguların en küçüğü 10 aylık, en büyüğü ise 17 yaşındaydı (ortalama 7,72±5,6, medyan 7). Ameliyat sonrası en kısa takip süresi 5 ay iken en uzun takip süresi 60 aydı.
48 pediatrik hastaya toplam 63 cerrahi işlem uygulandı. 17 piyeloplasti (sol 10, sağ 7), 9 Lich Gregoir ameliyatı (sağ 6, sol 3), 4 sol üreterovezikal bileşke obstrüksiyonu (UJO) nedeniyle üreteral reimplantasyon ve tapering, 3 Hemi nefrektomi, bir apendikovezikostomi, bir sağ üreteral reimplantasyon,11 Nissen fundoplikasyonu, 10 gastrostomi ve bir gastrojejunostomi, over kisti olan iki hastaya over koruyucu cerrahi uygulandı. Bir urakus remnant eksizyonu, bir adrenal kitle eksizyonu ve bir torasik outlet kitle eksizyonu yapıldı.
Sonuç: Bu çalışma, ülkemizde pediatrik robotik cerrahi prosedürlerin geniş bir yelpazesini içeren ilk çalışmadır. Çocuk cerrahisinde robot yardımlı laparoskopik işlemler birçok cerrahi patolojide güvenle uygulanabilmektedir. Başlangıçta bazı basit cerrahi işlemlerin ardından en az 15 vakadan sonra daha karmaşık işlemlere geçilmesinin daha uygun olacağını düşünüyoruz.
Anahtar Kelimeler
Kaynakça
- Salö M, Bonnor L, Graneli C, Stenström P, Anderberg M. Ten years of paediatric robotic surgery: Lessons learned. Int J Med Robot Comput Assist Surg (Internet) 2022 (cited 2022 Jul 6);(February). Available from: https://pubmed.ncbi.nlm.nih.gov/35240727/
- Arellano MN, González FG. Robot-assisted laparoscopic and thoracoscopic surgery: Prospective series of 186 pediatric surgeries. Front Pediatr 2019;7:1–9.
- Fuchs ME, DaJusta DG. Robotics in pediatric urology. Int Braz J Urol 2020;46:322–7.
- Meehan JJ, Meehan TD, Sandler A. Robotic fundoplication in children: resident teaching and a single institutional review of our first 50 patients. J Pediatr Surg 2007;42:2022–5.
- Silay MS, Spinoit AF, Undre S, Fiala V, Tandogdu Z, Garmanova T, et al. Global minimally invasive pyeloplasty study in children: Results from the Pediatric Urology Expert Group of the European Association of Urology Young Academic Urologists working party. J Pediatr Urol (Internet) 2016;12:229.e1-229.e7.
- Andolfi C, Kumar R, Boysen WR, Gundeti MS. Current Status of Robotic Surgery in Pediatric Urology. J Laparoendosc Adv Surg Tech A 2019;29:159-66.
- Lorincz A, Langenburg S, Klein MD. Robotics and the pediatric surgeon. Curr Opin Pediatr (Internet) 2003;15:262–6.
- Bansal D, Cost NG, DeFoor WR, Reddy PP, Minevich EA, Vanderbrink BA, et al. Infant robotic pyeloplasty: Comparison with an open cohort. J Pediatr Urol 2014;10:380–5.
- Cundy TP, Harling L, Hughes-Hallett A, Mayer EK, Najmaldin AS, Athanasiou T, et al. Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children. BJU Int (Internet) 2014;114:582–94.
- Finkelstein JB, Van Batavia JP, Casale P. Is outpatient robotic pyeloplasty feasible? J Robot Surg (Internet) 2016;10:233–7.
- Grimsby GM, Dwyer ME, Jacobs MA, Ost MC, Schneck FX, Cannon GM, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol (Internet) 2015;193(5 Suppl):1791–5.
- Gutt CN, Markus B, Kim ZG, Meininger D, Brinkmann L, Heller K. Early experiences of robotic surgery in children. Surg Endosc (Internet) 2002;16:1083–6.
- O’Kelly F, Farhat WA, Koyle MA. Cost, training and simulation models for robotic-assisted surgery in pediatric urology. World J Urol 2020;38:1875-82.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi |
| Bölüm | ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Mart 2023 |
| Gönderilme Tarihi | 18 Ocak 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 17 Sayı: 2 |