title: Robotic surgery and anesthesia for pediatric urologic procedures.
abstract: OBJECTIVE
  Minimally invasive approaches to pediatric surgery have become increasingly popular over the last 15 years. With the advent of robotically controlled instruments, common pediatric urologic surgeries such as pyeloplasty and ureteral reimplantation, which were previously technically challenging, are now commonly performed laparoscopically. It is important to recognize the unique physiologic considerations with this approach and how to provide safe and effective anesthesia for these procedures.
  
  
  RESULTS
  Although there are multiple studies in the surgical literature describing robot-assisted laparoscopic approaches for pediatric urologic surgery, there are few articles that describe the anesthetic considerations for this type of surgery in children. As the first pediatric hospital in the USA to obtain a surgical robot in 2001, a consistent, collaborative approach has been developed to care for infants and children undergoing robot-assisted laparoscopic surgery.
  
  
  CONCLUSIONS
  Robot-assisted laparoscopic surgery is increasingly utilized for common pediatric urologic surgeries. To provide safe and effective anesthesia for this type of surgery, it is important to have a thorough understanding of the multiple physiologic derangements that occur with robot-assisted laparoscopic surgery in infants and children, the potential complications that can occur with this approach and have a consistent approach to the anesthetic management and postoperative pain control for these procedures.
authors.affiliation: aDepartment of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts bBanner Children's Specialists, Pediatric Urology, Cardon Children's Medical Center, Mesa, Arizona, USA.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Muñoz
authors.forename: Hiep T
authors.initials: HT
authors.lastname: Nguyen
authors.forename: Constance S
authors.initials: CS
authors.lastname: Houck
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D002648:Child; D006801:Humans; D007327:Insufflation / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods; D059408:Pain Management / Q000295:instrumentation / Q000379:methods; D010149:Postoperative Pain / Q000628:therapy; D056888:Patient Positioning; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D012121:Respiration, Artificial / Q000379:methods; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014570:Urologic Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*