# Update Course Rewind 2025: Robotics in Pediatric Surgery: Which indications benefit the most? — GCMD Library This video series recaps highlights from the 13th Annual Pediatric Surgery Update Course. Dr. Juan Gurria discusses the pros and cons of robotic surgery in pediatric patients, comparing it to laparoscopic surgery, and exploring its future. The discussion covers surgical proficiency, cost-effectiveness, and various indications for robotic interventions in children.

For more information on Dr. Juan Gurria at Cincinnati Children's, click here: https://www.cincinnatichildrens.org/bio/g/juan-pablo-gurria
Type: video · 4 min · posted 2026-06-18 Canonical: https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230 ## Chapters - [0:00](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=0) Introduction and Advantages of Robotic Surgery - [1:08](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=68) Addressing Common Concerns About Robotic Surgery - [2:23](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=143) Clinical Outcomes and Proficiency Requirements - [3:38](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=218) Summary and Future Directions ## Statements - "All pediatric surgical patients discussed are good candidates for robotic surgery" — Jill Knepprath (opinion) [0:33](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=33) - "The human hand has 6 degrees of freedom for mobility, robotic has 7" — Juan Gurria (clinical) [0:41](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=41) - "Robotic surgery reduces postoperative pain and infection risk, leading to faster recovery" — Jill Knepprath (clinical) [1:02](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=62) - "The learning curve for robotic surgery is better than laparoscopic surgery" — Juan Gurria (clinical) [1:21](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=81) - "Time to reduce operative times is way faster for robotic than laparoscopic after a few cases" — Juan Gurria (clinical) [1:26](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=86) - "There is no FDA approval for robotic surgery in pediatrics, but it should be coming soon" — Juan Gurria (guideline) [1:42](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=102) - "After a few cases, robotic surgery decreases operative time" — Juan Gurria (clinical) [1:53](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=113) - "Improved efficiency and reduced operative time reduces costs for robotics in the long run" — Jill Knepprath (opinion) [1:56](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=116) - "New robotic systems allow surgeons to tell when the suture is about to rupture" — Juan Gurria (clinical) [2:05](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=125) - "Robotic surgery improves depth perception compared to laparoscopic surgery" — Jill Knepprath (clinical) [2:09](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=129) - "Robotic surgery reduces surgeon fatigue compared to laparoscopic surgery" — Jill Knepprath (clinical) [2:14](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=134) - "In colorectal surgery, robotic operative time is longer than laparoscopic" — Jill Knepprath (clinical) [2:23](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=143) - "Laparoscopy has a higher conversion rate to open surgery than robotic surgery in colorectal cases" — Jill Knepprath (clinical) [2:23](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=143) - "Both robotic and laparoscopic surgery have comparable oncologic results" — Jill Knepprath (clinical) [2:32](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=152) - "With trained personnel, room turnover time for robotic surgery equals that of laparoscopic surgery" — Juan Gurria (clinical) [2:37](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=157) - "Cases needed for basic proficiency: 20 to 30 for laparoscopy, 10 to 15 for robotic" — Juan Gurria (clinical) [2:51](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=171) - "It takes half the number of cases to become proficient in robotic surgery versus laparoscopy" — Jill Knepprath (clinical) [2:57](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=177) - "Robotic surgery does not impair outcomes in oncologic surgeries" — Juan Gurria (clinical) [3:07](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=187) - "Robotics can be indicated for surgeries in the chest, pelvic reconstruction, abdominal tumors, and urology" — Jill Knepprath (clinical) [3:14](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=194) - "In smaller patients, measure 3 centimeters between ports" — Jill Knepprath (clinical) [3:24](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=204) - "Future pediatric surgeons will be doing robotic surgery rather than laparoscopy" (opinion) [3:28](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=208) - "Robotic surgery in pediatric patients is ideal in select cases including adrenal masses, polycystic kidneys, and nephrectomies" — Jill Knepprath (clinical) [3:38](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=218) - "Reported cons of robotic surgery include cost, set up time, the size of the ports, and a steep learning curve" — Jill Knepprath (opinion) [3:52](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=232) - "Operative times and conversions to open surgery are lower for robotic surgery compared to laparoscopy once proficiency is achieved" — Jill Knepprath (clinical) [4:06](https://library.globalcastmd.com/watch/update-course-rewind-2025-robotics-in-pediatric-surgery-which-indications-benefit-the-most-12230?t=246) ## Transcript Global Cat MD along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe. I'm Jill Knerath with Stay Current MD. In this video series, we will be recapping some of the key highlights from our 13th annual update course in pediatric surgery. Today we will hear about robotic surgery from Dr. Juan Gurria, the surgical director of the Pancreas Care Center for Excellence and the surgical director for the PICU ECO program at Cincinnati Children's. Who is a candidate for robot case here? The answer is that All of these patients are good candidates for robotic surgery. So what are some of the advantages of robotic surgery in pediatrics? Perfect visualization, tiny incisions, the hand has 6 degrees of freedom for mobility, robotic has 7. That's unimaginable angles that you can reach with a robot up there near the diaphragm, back near the cave. Not only does it have greater range of motion than the human hand, it also improves visualization. and enhances precision. This reduces postoperative pain and infection risk, leading to a faster recovery. Some cons listed people think it's going to take me so long to learn this robot. The main debate is comparing robotic to laparoscopic surgery. Does robotic surgery have a higher learning curve than laparoscopy? If we look at laparoscopic versus robotic, the learning curve is better. Time to reduce your operative times is way faster than laparoscopic after a few cases. People who have access to the robot who don't use it, why don't you use it? 8 millimeter ports and it's not cost effective for us. Are there FDA indications for the robot for pediatric surgery? No, there's no FDA approval for it for pediatrics, but it should be coming soon. What about the concerns for the high initial cost for robotic surgery? So you're talking about cost. After a few cases, you're decreasing your operative time. Improved efficiency and reduced operative time actually reduces costs for robotics in the long run. Some people say you cannot feel anything. New systems in the current system, you can tell when the suture is about to rupture. Compared to laparoscopic surgery, robotic surgery improves depth perception. Increases tremors and reduces surgeon fatigue. You get your feedback from your eyes. You get used to it. It takes, it takes only a few cases to do that. In colorectal surgery, robotic operative time is longer than laparoscopic, but laparoscopy has a higher conversion rate to open surgery. Both robotic and laparoscopic surgery have comparable on. Logic results. It takes longer to set up. If you train your personnel, it will take the same amount of time to turn over the the the room for robot than for a lab. How many cases are needed to reach basic proficiency in laparoscopy versus robotic surgery? Cases needed for basic proficiency, 20 to 30 laparoscopy. Robotic, 10 to 15. So it takes half the number of cases to become proficient in robotic surgery versus laparoscopy. So that is going to decrease your operative times, increase the cost of the robot. That initial cost is about efficiency and outcomes because it does not impair outcomes in oncologic surgeries either. Robotics can be indicated for surgeries in the chest. Pelvic reconstruction, abdominal tumors, urology, and more. Some general tips are listed here. In smaller patients, measure 3 centimeters between ports. People that are coming into our field to do pediatric surgery, they are not going to be doing laparoscopy. They're going to be doing robotic surgery. So we need to embrace the reality of where the future is headed in doing robotic surgery. Summary, robotic surgery in pediatric patients is ideal in select cases, including adrenal masses, polyoco cysts, and nephrectomies. It offers better range of motion, visualization, and precision. Reported cons of robotic surgery include cost, set up time, the size of the ports, and a steep learning curve. However, it actually takes fewer cases to become proficient in robotic surgery compared to laparoscopy. And once this is achieved, the operative times and conversions to open surgery are lower for robotic surgery compared to laparoscopy. Robotic surgery produces comparable oncologic outcomes compared to laparoscopy, while reducing surgeon fatigue. This makes it an increasingly important part of the future of pediatric surgery. Global Cat MD along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai