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Review
. 2023 Dec 26;12(12):2256-2266.
doi: 10.21037/tp-23-251. Epub 2023 Dec 18.

Robotic-assisted laparoscopy in pediatric surgical oncology: a narrative review

Nicolas Vinit  1   2 , Sabine Sarnacki  1   2 , Thomas Blanc  1   2
Affiliations
Review

Robotic-assisted laparoscopy in pediatric surgical oncology: a narrative review

Nicolas Vinit et al. Transl Pediatr. .

Abstract

Background and objective: Robotic surgical oncology in children calls for experienced surgeons in minimally invasive surgery (MIS) and a solid oncological background. The aim of this review was to analyze the current state of robotic-assisted laparoscopy in pediatric tumor resection, assess the necessary framework of minimally invasive surgical oncology and describe future developments of the robotic technology.

Methods: A literature search of the MEDLINE/PubMed database was conducted, using the terms "robotic surgery", "pediatric" or "children" and "oncology" or "tumor". All relevant English-language studies published between 2008 and 2022 were reviewed.

Key content and findings: Although concerns have been raised regarding the use of MIS in surgical oncology, current literature reports similar oncological outcome if surgeons comply with the oncologic principles. The benefits of MIS have been established for robotic surgery in adult studies, including a shorter time to adjuvant chemotherapy. Surgical feasibility should be assessed based on tumor characteristics, preoperative imaging focusing on vascular involvement and surgeon's experience until clear guidelines are issued. The difficulties in establishing eligibility criteria for robotic resection of pediatric tumors lie in the great variability of indications, heterogeneity in tumor histology with their own surgical specificities, and wide range of age and weight, as shown by the literature review we performed. Between 2008 and 2022, 31 studies reported 171 cases with three studies including at least ten patients. The most reported procedure was adrenalectomy (41 cases). Current research in pediatric surgical oncology focuses on intraoperative locoregional treatment, improved vision with fluorescence and dyed-loaded specific probes and the many possibilities of enhancement software using the robotic console.

Conclusions: The robotic technology allows the surgeon to push the boundaries of conventional laparoscopy. Specific surgical guidelines are necessary.

Keywords: Robotic surgery; minimally invasive surgery (MIS); pediatric surgery; pediatric tumor; surgical oncology.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-23-251/coif). The series “Pediatric Robotic Surgery” was commissioned by the editorial office without any funding or sponsorship. T.B. is an official proctor in Intuitive Surgical. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of the reviewing process conducted on robotic-assisted surgical oncology in children.
See this image and copyright information in PMC

References

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