Robotic surgery in children's hospitals: Slight increase and common indications

Infographic · Feb 2021 · 1 min read

In brief

Multi-institutional analysis of 19 U.S. children's hospitals shows steady growth in robotic surgery adoption from 2010-2019, with expanding surgeon participation in both pediatric surgery and urology. Renal pelvis/ureter procedures dominate urologic cases while foregut surgery shows fastest growth in general pediatric surgery.

Robotic surgery in pediatric hospitals increased 1.3-2.0% per quarter from 2010-2019, with more surgeons adopting the technology.
Biliary/spleen procedures were most common (45.5%) but stable; foregut surgery showed fastest growth at 2.1% per quarter.
In pediatric urology, renal pelvis/ureter surgery comprised 55.8% of robotic cases and grew 2.2% per quarter.
Mediastinal/thoracic robotic surgery declined 4.6% per quarter, suggesting selective adoption based on procedure type.
Both case volume and number of operating surgeons increased, indicating broader institutional adoption beyond early adopters.

Written by the GCMD Library team from the infographic.

The infographic uses a red, white, and gray color scheme with icons representing a robotic surgical system, pediatric patients, surgeons, and anatomical organs. Bar charts with upward-trending red arrows illustrate growth patterns. The layout is divided into sections showing specialty areas, trend data, and most common procedures with corresponding visual icons.

Abstract

Background: A growing number of tertiary children's hospitals are utilizing robotic surgical technology. We sought to characterize national trends in pediatric surgical robotic case utilization and related drivers.

Methods: Pediatric urology and pediatric surgery (abdominal and thoracic) procedures, performed from January 2010 to December 2019 across 19 U.S. tertiary care children's hospitals, were identified using the Pediatric Health Information System (PHIS). Trends in robot utilization were evaluated by surgical subspecialty, procedure type, and number of individual operating surgeons.

Results: Increases were noted in the overall numbers of pediatric surgery (1.3% per quarter, p = 0.005) and urology robotic procedures (2.0% per quarter, p < 0.001), as well as the numbers of pediatric surgeons (7.5% per year, p < 0.001) and pediatric urologists (7.8% per year, p < 0.001) operating robotically. Biliary system and spleen surgery were the most common robotic pediatric surgery procedures (45.5%) and had stable utilization over time (- 0.8% per quarter, 95% CI - 2.3-0.8). Robotic foregut surgery showed the most rapid growth in utilization (2.1% per quarter, 95% CI 0.7-3.6, p = 0.004) in pediatric surgery, while mediastinal/thoracic surgery demonstrated a decrease in utilization (- 4.6%, 95% CI - 7.9-1.2, p = 0.008). Renal pelvis/ureter surgery was the most common robotic urologic procedure (55.8%) and also demonstrated the fastest growth utilization (2.2% per quarter, 95% CI 1.5-2.9, p < 0.001) in urology.

Conclusions: Utilization of robotic-assisted surgery in pediatric surgery and pediatric urology has increased both in case volume and the number of operating surgeons, with foregut and renal pelvis/ureter surgery responsible for the areas of greatest growth.

Keywords: Fundoplication; Innovation; Minimally invasive; Pediatric surgery; Pediatric urology; Trends.

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