title: Robot-assisted pediatric surgery: how far can we go?
abstract: BACKGROUND
  The purpose of this study was to assess the safety and feasibility of performing robot-assisted pediatric surgery using the da Vinci Surgical System in a variety of surgical procedures.
  
  
  METHODS
  A retrospective review of 144 robot-assisted pediatric surgical procedures performed in our institution between June 2004 and December 2007 was done. The procedures included the following: 39 fundoplications; 34 cholecystectomies; 25 gastric bandings; 13 splenectomies; 4 anorectal pull-through operations for imperforate anus; 4 nephrectomies; 4 appendectomies; 4 sympathectomies; 3 choledochal cyst excisions with hepaticojejunostomies; 3 inguinal hernia repairs; two each of the following: liver cyst excision, repair of congenital diaphragmatic hernia, Heller's myotomy, and ovarian cyst excision; and one each of the following: duodeno-duodenostomy, adrenalectomy, and hysterectomy.
  
  
  RESULTS
  A total of 134 procedures were successfully completed without conversion; 7 additional cases were converted to open surgery, and 3 were converted to laparoscopic surgery. There were no system failures (e.g., setup joint, arm, or camera malfunction; power error; monocular or binocular loss; metal fatigue or break of surgeon's console hand piece; software incompatibility). There was one esophageal perforation and two cases of transient dysphagia following Nissen fundoplication. The mean patient age was 8.9 years, and the mean patient weight was 57 kg.
  
  
  CONCLUSIONS
  Robot-assisted surgery appears to be safe and feasible for a number of pediatric surgical procedures. Further system improvement and randomized studies are required to evaluate the benefits, if any, and the long-term outcomes of robotic surgery.
authors.affiliation: Division of Pediatric Surgery, College of Medicine, King Saud University, P.O. Box 84147, Riyadh, 11671, Saudi Arabia. Qahtani@yahoo.com
authors.forename: Aayed
authors.initials: A
authors.lastname: Alqahtani
authors.forename: Abdullrahman
authors.initials: A
authors.lastname: Albassam
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zamakhshary
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shoukri
authors.forename: Tariq
authors.initials: T
authors.lastname: Altokhais
authors.forename: Ayman
authors.initials: A
authors.lastname: Aljazairi
authors.forename: Abdullrhman
authors.initials: A
authors.lastname: Alzahim
authors.forename: Mohammed
authors.initials: M
authors.lastname: Mallik
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alshehri
mesh_terms: D002648:Child; D005240:Feasibility Studies; D006801:Humans; D012189:Retrospective Studies; D012371:Robotics; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome