2025 Pediatric Surgery Update Course - Robotics in Pediatric Surgery: Which indications benefit the most?
With Dr. Juan Guria · hosted by Dr. Todd Ponsky · Live Event Content
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Four out of approximately 30 attendees perform robotic surgery; another 12 have robot access but do not use it
Robotic instruments have seven degrees of freedom compared to six for the human hand
Choledochal cyst is a perfect case for robotic surgery
Adrenalectomy for neuroblastoma confined to the adrenal is a perfect robotic case
Learning curve for basic proficiency is 20-30 cases for laparoscopy versus 10-15 cases for robotics
Initial cost premium for robotic surgery is approximately $4000 per case in most institutions
Each additional 15 minutes of operative time costs the same for robotic and laparoscopic surgery
Room turnover time for robotic cases can be reduced to 30 minutes with trained personnel
All pediatric surgery fellowships are integrating robotic training
Robotic surgery shows lower conversion to open rates compared to laparoscopy in colorectal cases
Median arcuate ligament release should not be performed laparoscopically or open anymore due to difficulty accessing the angle near the celiac trunk
There is no FDA approval for robotic systems in pediatric surgery
Robotic surgery is not recommended for appendectomy
ICG fluorescence allows visualization of adrenal arteries supplied by renal, diaphragmatic, and aortic vessels
The next generation of surgeons will not be proficient in laparoscopy if robotic surgery becomes dominant in training
Robotic surgery is not a standard of care but a tool to aid efficiency and access to difficult angles
Studies comparing robotic to laparoscopic surgery consistently show equivalence rather than superiority
Surgeons trained primarily in robotics cannot tie, sew, or work with 3mm instruments effectively
Patients are seeking out centers that offer robotic surgery, particularly in adult centers
ICG fluorescence in choledochal cyst surgery allows visualization far back to the head of the pancreas to achieve proper tapering, decreasing future cancer risk
New robotic systems with tactile sensors reduce force application by 83%
Yuri Kuzlov in Russia has performed over 300 robotic cases
General surgery residents report doing 75-80% of minimally invasive surgery robotically
Robotic surgery shows equivalent oncologic outcomes in certain tumor surgeries