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Eur J Pediatr Surg 2014; 24(02): 127-135
DOI: 10.1055/s-0033-1347297
Review
Georg Thieme Verlag KG Stuttgart · New York

Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

Thomas P. Cundy
1   The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
,
Hani J. Marcus
1   The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
,
James Clark
1   The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
,
Archie Hughes-Hallett
2   Department of Surgery and Cancer, Imperial College London, London, United Kingdom
,
Erik K. Mayer
2   Department of Surgery and Cancer, Imperial College London, London, United Kingdom
,
Azad S. Najmaldin
3   Department of Paediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom
,
Guang-Zhong Yang
1   The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
,
Ara Darzi
1   The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
› Author Affiliations
Further Information

Publication History

07 April 2013

11 April 2013

Publication Date:
17 May 2013 (online)

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Abstract

Introduction Open surgery remains the primary technique for resection of pediatric solid tumors despite the popularity of minimally invasive surgery (MIS) for oncological indications in adults and nononcological indications in children. Robot-assisted surgery offers technical and ergonomic advantages that might make MIS more achievable in this setting, permitting benefits for both the patient and surgeon. The aim of this study is to critically appraise the current status of robot-assisted MIS for pediatric solid tumors.

Materials and Methods A systematic search of multiple electronic literature databases was undertaken, supplemented by several relevant secondary sources.

Results A total of 23 publications met eligibility criteria, reporting 40 cases overall. Indications for surgery were widely varied, with over 20 different pathologies described. One-third of tumors were classified as malignant. Most procedures involved abdominal or retroperitoneal located tumors in adolescent patients (age range, 1–18 years). The collective complication and conversion rates were 10% and 12.5%, respectively. Oncological adverse events involved two isolated events of tumor spillage and residual disease. The evidence is limited to case reports and small case series only.

Conclusions For the diverse and highly selective cases in this review, robot-assisted MIS seems safe and feasible. Current status is low volume, in a relatively static state of adoption, and without any apparent index pathology or procedure. The benefits of robot assistance seem well suited but remain unsubstantiated by evidence. Higher quality studies are needed to determine true safety and efficacy.

Keywords

robot - pediatric - neoplasm - children - cancer
 

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