The Robotic Surgery, Research and Training Center and the Department of Urology, Boston Children's Hospital, Boston, MA, USA.
J Pediatr Urol. 2013 Dec;9(6 Pt B):1198-203. doi: 10.1016/j.jpurol.2013.05.011. Epub 2013 Jun 17.
To determine the feasibility and safety of performing robotic-assisted laparoscopic urological surgery (RALS) in infants and young children, highlighting technical challenges posed by the smaller body size and their potential solutions.
We retrospectively reviewed perioperative records of all patients less than 3 years of age who underwent RALS at our institution between January 2006 and October 2012. Intraoperative data included difficulties with the robotic instruments or surgical procedure. Post-operative data included length of hospital stay and any complications.
A total of 65 children less than 3 years underwent RALS. The average patient age was 1.6 years ± 0.7, with 14 patients under 1 year of age. Median patient weight was 11.6 kg ± 2.5 kg. Mean operative time was 153.3 ± 57 min. No conversions to open technique or intra-operative complications were reported. A total of 12 post-operative complications were identified after a mean follow-up of 13.6 months: 7 early complications and 5 late complications. Smaller children did not have more complications than larger children.
There are inherent challenges with performing RALS in infants and young children. However, they may be overcome with specific technical maneuvers and through understanding of the limitations of the robotic system.
确定在婴儿和幼儿中进行机器人辅助腹腔镜泌尿外科手术（RALS）的可行性和安全性，重点介绍由较小的体型带来的技术挑战及其潜在解决方案。
我们回顾性分析了 2006 年 1 月至 2012 年 10 月期间在我们机构接受 RALS 的所有年龄小于 3 岁的患者的围手术期记录。术中数据包括机器人器械或手术程序的困难。术后数据包括住院时间和任何并发症。
共有 65 名年龄小于 3 岁的儿童接受了 RALS。平均患者年龄为 1.6 岁±0.7 岁，其中 14 名患者年龄小于 1 岁。中位患者体重为 11.6kg±2.5kg。平均手术时间为 153.3±57 分钟。没有转为开放技术或术中并发症的报告。平均随访 13.6 个月后，共发现 12 例术后并发症：7 例早期并发症和 5 例晚期并发症。较小的儿童与较大的儿童相比并没有更多的并发症。
在婴儿和幼儿中进行 RALS 存在固有挑战。然而，通过特定的技术操作并了解机器人系统的局限性，可以克服这些挑战。
