title: The first decade of robotic surgery in children.
abstract: BACKGROUND
  Robotic surgery offers technological solutions to current challenges of minimal access surgery, particularly for delicate and dexterous procedures within spatially constrained operative workspaces in children. The first robotic surgical procedure in a child was reported in April 2001. This review aims to examine the literature for global case volumes, trends, and quality of evidence for the first decade of robotic surgery in children.
  
  
  METHODS
  A systematic literature search was performed for all reported cases of robotic surgery in children during the period of April 2001 to March 2012.
  
  
  RESULTS
  Following identification of 220 relevant articles, 137 articles were included, reporting 2393 procedures in 1840 patients. The most prevalent gastrointestinal, genitourinary, and thoracic procedures were fundoplication, pyeloplasty, and lobectomy, respectively. There was a progressive trend of increasing number of publications and case volumes over time. The net overall reported conversion rate was 2.5%. The rate of reported robot malfunctions or failures was 0.5%.
  
  
  CONCLUSIONS
  Robotic surgery is an expanding and diffusing innovation in pediatric surgery. Future evolution and evaluation should occur simultaneously, such that wider clinical uptake may be led by higher quality and level of evidence literature.
authors.affiliation: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, United Kingdom. t.cundy@imperial.ac.uk
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Cundy
authors.forename: Kunal
authors.initials: K
authors.lastname: Shetty
authors.forename: James
authors.initials: J
authors.lastname: Clark
authors.forename: Tou Pin
authors.initials: TP
authors.lastname: Chang
authors.forename: Kumuthan
authors.initials: K
authors.lastname: Sriskandarajah
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Gattas
authors.forename: Azad
authors.initials: A
authors.lastname: Najmaldin
authors.forename: Guang-Zhong
authors.initials: GZ
authors.lastname: Yang
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002648:Child; D006801:Humans; D010372:Pediatrics; D012371:Robotics; D025321:Surgery, Computer-Assisted