Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA.
Curr Urol Rep. 2024 Oct 3;26(1):8. doi: 10.1007/s11934-024-01231-7.
Detail the evolution, utility, and future directions of the da Vinci SP® in pediatric urology, focusing on perioperative outcomes and intraoperative details.
The SP has been safely and successfully utilized in various pediatric urological procedures, from pyeloplasty to nephroureterectomy to appendicovesicostomy. Reports indicate mixed operative times but similar hospital stays and postoperative outcomes compared to multiport (MP) robotic surgery. The learning curve for transitioning from MP to SP systems in pediatric patients appears manageable, though the smaller abdominal circumference in children poses a notable challenge. This review assumes that SP systems will primarily be acquired for adult services, not considering initial and ongoing costs to hospital systems. The SP serves as a complementary option, rather than a replacement, for MP robotic surgery in pediatric urology, offering potential advantages in specific scenarios. Cosmetic outcomes with the SP appear at least as favorable as MP surgery, but further research is needed. Future research should focus on patient-centered outcomes to optimize SP robotic surgery use in pediatric patients.
详细介绍达芬奇 SP® 在小儿泌尿外科中的发展、应用及未来方向,重点关注围手术期结果和手术细节。
SP 已安全、成功地应用于各种小儿泌尿科手术,包括肾盂成形术、肾输尿管切除术和阑尾-膀胱吻合术。报告显示,与多孔(MP)机器人手术相比,其手术时间有所不同,但住院时间和术后结果相似。从 MP 到 SP 系统在小儿患者中的过渡学习曲线似乎是可控的,尽管儿童的腹部周长较小是一个显著的挑战。本综述假设 SP 系统主要将用于成人服务,而不考虑医院系统的初始和持续成本。SP 是小儿泌尿外科 MP 机器人手术的补充选择,而不是替代,在特定情况下具有潜在优势。SP 的美容效果至少与 MP 手术一样好,但仍需要进一步研究。未来的研究应侧重于以患者为中心的结果,以优化 SP 机器人手术在小儿患者中的应用。