Casale Pasquale
Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Expert Rev Med Devices. 2008 Jan;5(1):59-64. doi: 10.1586/17434440.5.1.59.
The number of current advances in robotic surgery for the pediatric population is growing every day: the different procedures range from extirpative to reconstructive, including pyeloplasty, reimplantation, catheterizable channels and augmentation. Despite its early success, robotic surgery still poses many challenges in pediatric patients. Robotics also allows the seasoned laparoscopist to become more proficient and refined, providing a greater armamentarium to expand minimally invasive surgery to more complex reconstructive procedures. The procedure most performed with the da Vinci Surgical System in pediatric urology is pyeloplasty for ureteropelvic junction obstruction. There are many other procedures that can be performed with the robot, such as ureteral reimplantation, and nephrectomy, both total and partial. The reconstructive aspect has been taken to the next level where more difficult procedures, such as appendicovesicostomy and bladder augmentation, can be performed in children.
不同的手术范围从切除性手术到重建性手术，包括肾盂成形术、再植术、可插管通道手术和膀胱扩大术。尽管早期取得了成功，但机器人手术在儿科患者中仍面临许多挑战。机器人技术也使经验丰富的腹腔镜手术医生更加熟练和精细，为将微创手术扩展到更复杂的重建手术提供了更多手段。在小儿泌尿外科中，使用达芬奇手术系统进行最多的手术是肾盂成形术以治疗输尿管肾盂连接部梗阻。还有许多其他手术也可以通过机器人进行，例如输尿管再植术以及全肾和部分肾切除术。重建方面已经提升到了一个新的水平，在儿童中可以进行更困难的手术，如阑尾膀胱造口术和膀胱扩大术。
