Estrada Carlos R, Passerotti Carlo C
Children's Hospital Boston, Dept. of Urology, 300 Longwood Avenue, HU390, Boston, MA 02115, USA.
Arch Esp Urol. 2007 May;60(4):471-9. doi: 10.4321/s0004-06142007000400017.
To review the use of robotic surgery in pediatric urology and provide a platform from which discussions regarding this technology can arise.
The available literature and the experience at the author's institution were reviewed to examine the applications of robotic surgery in pediatric urology. MEDLINE was queried using the following key words: robot, robotic, laparoscopy, surgery, child, and pediatrics.
The available literature is comprised mainly of case reports and case series. Two groups have published small analyses comparing robotic assisted laparoscopic pyeloplasty and open pyeloplasty. At our institution, we have utilized the daVinci robotic surgical system to perform the following surgical procedures: orchidopexy of the intraabdominal testis, total and partial nephrectomy, dismembered pyeloplasty, pyelolithotomy, excision of calyceal diverticula, ureteroureterostomy, ureteropyelostomy, intra- and extravesical ureteral reimplantation, megaureter' tapering and reimplantation, adrenelectomy, creation of a Mitrofanoff continent catheterizable channel, and resection of pelvic Mullerian remnants.
Robotic surgery in pediatric urology is an evolving technology that holds promise for application to most urological surgeries. Refinements in equipment will improve the efficiency of these systems. Ultimately, the efficacy and role of robotic surgical systems need to be defined with rigorous prospective studies that provide comparisons to gold standard techniques, be they open surgery or conventional laparoscopy.
回顾机器人手术在小儿泌尿外科中的应用，并提供一个引发关于该技术讨论的平台。
回顾现有文献以及作者所在机构的经验，以研究机器人手术在小儿泌尿外科中的应用。使用以下关键词在MEDLINE上进行查询：机器人、机器人辅助、腹腔镜检查、手术、儿童和儿科学。
现有文献主要由病例报告和病例系列组成。两组发表了小型分析，比较了机器人辅助腹腔镜肾盂成形术和开放性肾盂成形术。在我们机构，我们使用达芬奇机器人手术系统进行了以下手术：腹腔内睾丸的睾丸固定术、全肾和部分肾切除术、离断性肾盂成形术、肾盂切开取石术、肾盏憩室切除术、输尿管输尿管吻合术、输尿管肾盂吻合术、膀胱内和膀胱外输尿管再植术、巨输尿管变细和再植术、肾上腺切除术、创建可控性造口通道以及盆腔苗勒氏残余物切除术。
小儿泌尿外科中的机器人手术是一项不断发展的技术，有望应用于大多数泌尿外科手术。设备的改进将提高这些系统的效率。最终，机器人手术系统的疗效和作用需要通过严格的前瞻性研究来确定，这些研究要与金标准技术（无论是开放手术还是传统腹腔镜检查）进行比较。
