Department of General Pediatric Surgery and Pediatric Urology, CHU Tours, F-37000, Tours, France.
Surg Endosc. 2013 Jun;27(6):2137-44. doi: 10.1007/s00464-012-2729-y. Epub 2013 Jan 26.
Both our teams were the first to implement pediatric robotic surgery in France. The aim of this study was to define the key points we brought to light so other pediatric teams that want to set up a robotic surgery program will benefit.
We reviewed the medical records of all children who underwent robotic surgery between Nov 2007 and June 2011 in both departments, including patient data, installation and changes, operative time, hospital stay, intraoperative complications, and postoperative outcome. The department's internal organization, the organization within the hospital complex, and cost were evaluated.
A total of 96 procedures were evaluated. There were 38 girls and 56 boys with average age at surgery of 7.6 years (range, 0.7-18 years) and average weight of 26 kg (range, 6-77 kg). Thirty-six patients had general surgery, 57 patients urologic surgery, and 1 thoracic surgery. Overall average operative time was 189 min (range, 70-550 min), and average hospital stay was 6.4 days (range, 2-24 days). The procedures of 3 patients were converted. Median follow-up was 18 months (range, 0.5-43 months). Robotic surgical procedure had an extra cost of
Our experience was similar to the findings described in the literature for feasibility, security, and patient outcomes; we had an overall operative success rate of 97 %. Three main actors are concerned in the implementation of a robotic pediatric surgery program: surgeons and anesthetists, nurses, and the administration. The surgeon is at the starting point with motivation for minimally invasive surgery without laparoscopic constraints. We found that it was possible to implement a long-lasting robotic surgery program with comparable quality of care.
我们的两个团队都是法国首批开展小儿机器人手术的团队。本研究旨在确定我们发现的关键点，以便其他希望开展机器人手术项目的儿科团队从中受益。
我们回顾了两个部门 2007 年 11 月至 2011 年 6 月期间所有接受机器人手术的儿童的病历，包括患者数据、安装和变更、手术时间、住院时间、术中并发症和术后结果。评估了部门内部组织、医院内部组织以及成本。
共评估了 96 例手术。患者中有 38 名女孩和 56 名男孩，手术时的平均年龄为 7.6 岁（范围为 0.7-18 岁），平均体重为 26 公斤（范围为 6-77 公斤）。36 例为普通外科手术，57 例为泌尿外科手术，1 例为胸外科手术。总体平均手术时间为 189 分钟（范围为 70-550 分钟），平均住院时间为 6.4 天（范围为 2-24 天）。有 3 例患者的手术被转为传统手术。中位随访时间为 18 个月（范围为 0.5-43 个月）。与传统开放手术相比，机器人手术的额外费用为<欧元>1934 。
我们的经验与文献中描述的可行性、安全性和患者结局相似；我们的总体手术成功率为 97%。在实施小儿机器人手术项目时，有三个主要角色：外科医生和麻醉师、护士和管理人员。外科医生是起点，他具有开展微创手术的动力，不受腹腔镜的限制。我们发现，实施一个持久的机器人手术项目并保持同等的护理质量是可能的。
