Five millimetre-instruments in paediatric robotic surgery: Advantages and shortcomings. Issue 3 (June 2014)

• Record Type: Journal Article
• Authors: Pelizzo, Gloria; Nakib, Ghassan; Romano, Piero; Avolio, Luigi; Mencherini, Simonetta; Zambaiti, Elisa; Raffaele, Alessandro; Stoll, Timothée; Mineo, Nicolò; Calcaterra, Valeria
• Is Part Of: Minimally invasive therapy & allied technologies. Volume 24:Issue 3(2015)
• Page Start: 148
• Page End: 153
• Publication Date: 2014-06
• Subjects: Endoscopy -- Periodicals; Interventional radiology -- Periodicals; Endoscopic surgery -- Periodicals; 617.05
• DOI: 10.3109/13645706.2014.975135
• Languages: English
• ISSNs: 1364-5706

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Purpose:</italic> </bold> The study was designed to assess the utility and controversies surrounding the usage of 5-mm instruments in paediatric robotic surgery. Adequate, delicate instruments for surgery in very narrow spaces are still lacking. <bold><italic>Material and methods</italic></bold>: Thirty children underwent elective abdominal robotic surgery. Working sites, assembly and operative time, hospital stay, advantages, complications and shortcomings are reported. <bold><italic>Results</italic></bold>: Interventions were performed in the following anatomical sites: 11 upper abdominal, nine pelvic, ten renal procedures. The majority of procedures required two operative trocars. A 2–3 mm accessory port was necessary for operations in the renal area and upper abdomen. The ports had to be placed at least 3 cm from the costal margins and superior iliac spines and at an angle of at least 130° with respect to the camera trocar. This configuration allowed intra-corporal knotting, vessel ligation and dissection with instruments in the inverted position. Operative times and hospital stays were similar to those reported for 8 mm-instruments. <bold><italic>Conclusion</italic></bold>: The use of 5-mm instruments was advantageous in renal and pelvic sites. The benefits in upper abdominal surgery need further evaluation, particularly in patients weighing <10 kg. Smaller sized instruments with high endowrist dexterity would resolve the problems encountered in paediatric robotic-assisted surgery using 5-mm instruments.</p> </abstract>