Introduction
The advent of minimally invasive surgery (MIS) represents one of the most important surgical developments of the modern era. It has seen significant growth and development over the past 30 years. The benefits of MIS compared with traditional open surgery are well recognized. These include a reduction in post-operative pain, inpatient length of stay, wound complications, improved cosmesis, and an earlier return to normal activity.
The advent of robotic surgery has revolutionized the field of paediatric urology over the last two decades. At the turn of the century, the first robotic-assisted laparoscopic surgeries (RALS) within the field were performed, and less than two decades later, many became the treatment of choice and even redefined the new standard of care.
Milestones and Growth
The introduction of laparoscopic surgery within paediatric urology in the 1980s laid the groundwork for robotic surgery. Since the advent of robotic-assisted surgery within paediatric urology over two decades ago, the estimated yearly case volume has increased an average of 240% per year.
Newer Machines
The Da Vinci Surgical System from Intuitive Surgical, Inc., introduced in 1999, has been a game-changer in the field of robotic surgery. The system offers a stable 3-dimensional view, improved ergonomics, and a greater range of motion. The Da Vinci 5, the most advanced and integrated platform, was introduced recently, offering unprecedented capabilities and enhancing control and precision.
Other advancements include the British-designed Versius robot and a robotic arm called Mako, which is helping create incredibly precise replacements based on individual anatomy. Newer systems are also focusing on improved haptic feedback systems, flexible scopes, easier maneuverability, and even adaptive machine learning concepts.
Most Common Surgical Procedures
The most common application of robotic surgery in paediatric urology is pyeloplasty, followed by ureteral reimplantation. These procedures dominate the literature, accounting for 83% of the reported cases.
Future Prospects
The future of robotic surgery in paediatric urology looks promising. There are unique opportunities to continue to advance the field with new technology including 3D printing and fluorescent imaging. As paediatric urology continues to utilize robotic technology for minimally invasive surgery, there is hope that additional pediatric-friendly instruments and components will be developed.
Looking Ahead: The future of robotic surgery in pediatrics is brimming with possibilities. Here are some exciting prospects:
Telepresence surgery: Imagine a surgeon operating on a child remotely using robotic technology. This could be a game-changer for geographically isolated areas with limited access to pediatric surgical expertise.
Artificial intelligence integration: AI could assist surgeons in real-time, analyzing data and suggesting optimal surgical strategies for even more precise procedures.
Standardization and cost reduction: As robotic surgery becomes more commonplace, standardization of procedures and advancements in technology could lead to cost reductions, making it more accessible to a wider range of patients.
Conclusion
In conclusion, the growth of robotic surgery in paediatric urology has been significant and continues to evolve. With the advent of newer machines and the promise of future advancements, the field is set to redefine the standards of care in paediatric urology.
Stay tuned.... In the next blog post I shall discuss all the currently available robotic systems and compare them
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