Robot-assisted Surgery in Pediatric Patients: Results of a French Multicenter Study on 1401 Patients

IF 2.5 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-06-03 DOI:10.1016/j.jpedsurg.2025.162397

Quentin Ballouhey , Ciro Esposito , Kiarash Taghavi , Hubert Lardy , Nicolas Berte , Olivier Abbo , Marc David Leclair , Sarah Garnier , Matthieu Peycelon , Géraldine Hery , Aurélien Scalabre , Pierre Meignan , Carmen Capito , Pauline Lopez , Sabine Sarnacki , Laurent Fourcade , Alexis P. Arnaud , Thomas Blanc

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引用次数: 0

Abstract

Introduction

Establishing a robotic program in pediatric surgery remains challenging, with evidence-based practices still evolving. Over the last five years, robot-assisted surgery (RAS) has become the standard approach for several pediatric indications. This study presents the first national analysis of pediatric RAS in France, aiming to evaluate indications, procedural trends, and technical considerations.

Methods

A retrospective, multi-institutional study was conducted across 11 French centers with active pediatric robotic programs over the period 2007–2020. Clinical and organizational data were collected through standardized questionnaires and centralized database analysis. A Surgical Complexity Score (SCS) was developed to classify procedures.

Results

A total of 1401 RAS procedures were performed, including 301 children <15 kg and 93 < 10 kg. Centers handled a median of 1.4 cases/month, with 91 types of procedures performed. The 5 most frequent procedures were pyeloplasty (34 %), nephrectomy (12.7 %), antireflux surgery (9.2 %), ureteral reimplantation (5.7 %), and biliary procedures (5.6 %). Over time, procedural complexity increased, with 204 cases classified as high complexity (SCS 3). A strong correlation was observed between center experience and inclusion of patients <15 kg (r = 0.873; p = 0.0004), while conversion rates (3 %) were not influenced by experience. Twenty-four fellows were trained using standardized curricula and dual-console platforms.

Conclusions

Pediatric RAS has significantly grown in France, proving to be safe and feasible even in infants under 10 kg. Urology remains the main indication, followed by gastrointestinal and biliary surgery. Despite current limitations-especially instrument size-RAS offers advantages in precision, ergonomics, and surgical education. Future innovation may enhance its broader adoption in pediatric surgery.

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儿童患者的机器人辅助手术：法国一项涉及1401名患者的多中心研究结果。

在儿科外科中建立机器人项目仍然具有挑战性，基于证据的实践仍在不断发展。在过去的五年中，机器人辅助手术（RAS）已经成为几种儿科适应症的标准方法。这项研究提出了法国儿科RAS的第一个国家分析，旨在评估适应症、手术趋势和技术考虑。方法：一项回顾性的多机构研究在2007-2020年期间在11个法国中心进行了活跃的儿科机器人项目。通过标准化问卷调查和集中数据库分析收集临床和组织资料。采用手术复杂性评分（SCS）对手术进行分类。结果：共实施1401例RAS手术，其中包括301例儿童。结论：儿童RAS在法国显著增长，即使在10公斤以下的婴儿中也被证明是安全可行的。泌尿外科仍然是主要适应症，其次是胃肠道和胆道手术。尽管目前的限制，特别是仪器尺寸，ras在精度，人体工程学和外科教育方面具有优势。未来的创新可能会使其在儿科手术中得到更广泛的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.