title: Robot-assisted surgery: current status evaluation in abdominal and urological pediatric surgery.
abstract: OBJECTIVE
  The last two decades have witnessed a dramatic development of minimally invasive surgery (MIS). Robotic-assisted surgery is currently the latest step in the evolution of MIS. MIS was initially developed for adult surgery, but its use has progressively been extended to pediatrics. As for all new technologies, an objective evaluation is essential to adopt the robot in the practice of pediatrics.
  
  
  METHODS
  This article reviews the spectrum of evidence regarding the feasibility, safety, benefits, and limitations of abdominal and urological robot-assisted surgery in children. This analysis was performed using the PubMed database, using key words such as "robot," "robotic surgery," "robot-assisted," "da Vinci," and "computer-enhanced surgery" combined with "child," "children," "infants," and "pediatric."
  
  
  RESULTS
  In total, 88 studies met the selection criteria for our review. Only 10 studies comparing robotic surgery with open or conventional laparoscopic surgery are available for abdominal or urological pediatric procedures. Fundoplication for gastroesophageal reflux and pyeloplasty for hydronephrosis represent the most frequent procedures performed with robotic assistance in children.
  
  
  CONCLUSIONS
  Robotic surgery is suitable in the pediatric practice, which necessitates fine dissections and sutures in narrow anatomical spaces. The initial results of robotic surgery in the field of pediatrics are encouraging. Further prospective and comparative studies, especially between robotic and laparoscopic approaches, are required to confirm these preliminary results.
authors.affiliation: Department of Pediatric Surgery, Hospital Saint-Jacques, Centre Hospitalier Regional Universitaire de Besançon, Besançon, France. yannchaussy@hotmail.com
authors.forename: Yann
authors.initials: Y
authors.lastname: Chaussy
authors.forename: François
authors.initials: F
authors.lastname: Becmeur
authors.forename: Hubert
authors.initials: H
authors.lastname: Lardy
authors.forename: Didier
authors.initials: D
authors.lastname: Aubert
mesh_terms: D000005:Abdomen / Q000601:surgery*; D002648:Child; D006801:Humans; D012371:Robotics; D013520:Urologic Surgical Procedures / Q000379:methods*