Pediatric robot-assisted surgery: realities and prospects for use

The article provides an overview of pediatric robot-assisted surgery: the history of the technique, the main robot-assisted platforms, the available evidence base, advantages, and disadvantages. It has been proven that the data available in the literature regarding the expediency of using minimally invasive surgery remain quite limited. The main direction that requires further refinement is the development of robotic tools capable of working in small body cavities. In addition, the use of robotic techniques in some areas is still limited due to the lack of large comparative studies. We analyzed literature data on the successful use of abdominal robot-assisted surgery among pediatric patients in robotic gastric fundoplication, minimally invasive hepatobiliary surgery, splenectomy, herniotomy, Hirschsprung’s disease, pediatric urology, and oncology. The main shortcomings and future prospects of the development of robotic surgery in pediatric practice are considered, namely, high financial costs for the equipment and its further maintenance, high prices for replaceable disposable equipment, technical limitations, and the duration of training. In the future, due to an increase in the number of operations and a potential competitive market, robotic surgery can lead to a reduction in direct costs, mainly due to a reduction in the length of hospitalization. Minimally invasive surgery in pediatric practice is a relatively new field that has been developing over the past two decades and needs the development of new techniques and instruments that require less port distance or single port access. However, recent studies, including systematic reviews, meta-analyses, comparative studies, and prospective case series, have demonstrated the safety and feasibility of laparoscopic surgery for many congenital and acquired surgical diseases in children. Robotic minimally invasive surgery is a promising technique that has unconditional future prospects.