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Pediatric robotics

William E Bennett, Benjamin M Whittam, Konrad M Szymanski, Richard C Rink, Mark P Cain, Aaron E Carroll
The objective of this study is to determine the cost and charge differences between patients undergoing open vs. robotic pyeloplasty. This is a retrospective analysis of the Pediatric Health Information System (PHIS) database in patients undergoing pyeloplasty between 2004 and 2013 conducted in large pediatric children's hospitals in the United States which contribute to PHIS. The participants included all pediatric patients undergoing pyeloplasty at these institutions. We assessed RCC-based cost, charge details, length of stay, and the presence of complications, and compared them between open and robotic cases...
October 20, 2016: Journal of Robotic Surgery
S Setia, J Jackson, C D Herndon, S Corbett
Delayed sequelae following conservative management of renal trauma in the pediatric population are uncommon. Reports of delayed operations to manage these sequelae are even less common. Here we present the case of a 16-year-old male patient who had delayed development of upper urinary tract obstruction with recurrent infections following high-grade renal trauma managed conservatively. Ultimately he required a robotic-assisted partial nephrectomy two years after initial non-operative management. This is unique as no prior studies to our knowledge have described delayed hydronephrosis and delayed partial nephrectomy over a year following renal trauma...
October 17, 2016: Urology
C Elaine Little, Carolyn Emery, Stephen H Scott, Willem Meeuwisse, Luz Palacios-Derflingher, Sean P Dukelow
BACKGROUND: KINARM end point robotic testing on a range of tasks evaluating sensory, motor and cognitive function in children/adolescents with no neurologic impairment has been shown to be reliable. The objective of this study was to determine whether differences in baseline performance on multiple robotic tasks could be identified between pediatric/adolescent ice hockey players (age range 10-14) with and without a history of concussion. METHODS: Three hundred and eighty-five pediatric/adolescent ice hockey players (ages 10-14) completed robotic testing (94 with and 292 without a history of concussion)...
October 12, 2016: Journal of Neuroengineering and Rehabilitation
P H Smith, M Carpenter, K W Herbst, C Kim
INTRODUCTION: Minimally invasive surgery has become an important aspect of Pediatric Urology fellowship training. In 2014, the Accreditation Council for Graduate Medical Education published the Pediatric Urology Milestone Project as a metric of fellow proficiency in multiple facets of training, including laparoscopic/robotic procedures. OBJECTIVE: The present study assessed trends in minimally invasive surgery training and utilization of the Milestones among recent Pediatric Urology fellows...
September 15, 2016: Journal of Pediatric Urology
A C Wiestma, C R Estrada, P S Cho, M V Hollis, R N Yu
INTRODUCTION: Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient. METHODS: The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations...
August 21, 2016: Journal of Pediatric Urology
Eleni Papathanasiou, Mathilde Chevignard, Carole Vuillerot, Anne Tiberghien, Ingrid Godard
OBJECTIVE: Paediatric stroke is a relatively rare medical condition, but it often leads to long lasting motor and cognitive impairments. Rehabilitation of motor impairments has been widely studied, with most studies performed in children with cerebral palsy (CP). However, CP covers a variety of medical conditions, including brain lesions due to paediatric stroke occurring early in life, but not stroke occurring later on during childhood. The specificity of rehabilitation after paediatric stroke remains understudied...
September 2016: Annals of Physical and Rehabilitation Medicine
Aseem R Shukla
No abstract text is available yet for this article.
September 6, 2016: Journal of Pediatric Urology
Geneviève Bouchard-Fortier, Raymond H Kim, Lisa Allen, Abha Gupta, Taymaa May
OBJECTIVE: To report three cases of embryonal rhabdomyosarcoma (ERMS) of the cervix in young women successfully treated with fertility-sparing surgery and chemotherapy. METHODS: Between January 2014 and December 2015, three cases of ERMS of the cervix were confirmed in young women at a single tertiary cancer center. All cases were managed by a pediatric oncologist and a gynecologic oncologist with a combination of surgery and chemotherapy. Fertility-sparing surgeries (cervical conization or robotic-assisted radical trachelectomy) were offered to patients depending on the tumor size...
November 2016: Gynecologic Oncology Reports
Sharon H Gnagi, David R White
PURPOSE OF REVIEW: To discuss current modalities of endoscopic airway management beyond balloon dilation therapy. RECENT FINDINGS: Advances continue to be made through technology and bioengineering with exciting potential in the pediatric airway. Smaller robots and instrumentation allow increased endoscopic surgical success. Biodegradable stents and bioengineered grafts are on the horizon for use in airway surgery. Dysphonia following airway reconstruction is of increasing recognition with new endoscopic treatments being performed...
September 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Michael P Kurtz, Jeffrey J Leow, Briony K Varda, Tanya Logvinenko, Richard N Yu, Caleb P Nelson, Benjamin I Chung, Steven L Chang
INTRODUCTION: We sought to compare complications and direct costs for open ureteral reimplantation (OUR) versus robot-assisted laparoscopic ureteral reimplantation (RALUR) in a sample of hospitals performing both procedures. Anecdotal reports suggest that use of RALUR is increasing, but little is known of the outcomes and costs nationwide. OBJECTIVE: The aim was to determine the costs and 90-day complications (of any Clavien grade) in a nationwide cohort of pediatric patients undergoing OUR or RALUR...
August 23, 2016: Journal of Pediatric Urology
Karl D Price, Vivian W Sin, Charles Mougenot, Samuel Pichardo, Thomas Looi, Adam C Waspe, James M Drake
PURPOSE: Current treatment of intraventricular hemorrhage (IVH) involves cerebral shunt placement or an invasive brain surgery. Magnetic resonance-guided focused ultrasound (MRgFUS) applied to the brains of pediatric patients presents an opportunity to treat IVH in a noninvasive manner, termed "incision-less surgery." Current clinical and research focused ultrasound systems lack the capability to perform neonatal transcranial surgeries due to either range of motion or dexterity requirements...
September 2016: Medical Physics
Filippo Montevecchi, Chiara Bellini, Giuseppe Meccariello, Paul T Hoff, Elisa Dinelli, Iacopo Dallan, Ruggero M Corso, Claudio Vicini
Pediatric obstructive sleep apnea syndrome (OSAS) is primarily caused by adenotonsillar hypertrophy. However, tongue base hypertrophy is increasingly being recognized as a cause, even after adenotonsillectomy. We report three cases of pediatric OSAS successfully treated by transoral robotic reduction of the tongue base. In all children, we were able to achieve improved retrolingual patency while avoiding significant procedure-related morbidity. In conclusion, tongue base reduction by transoral robotic surgery appears to be a feasible solution for the base of tongue obstruction due to lingual tonsil hypertrophy in pediatric patients...
August 27, 2016: European Archives of Oto-rhino-laryngology
Michael J Biles, Julia B Finkelstein, Mark V Silva, Sarah M Lambert, Pasquale Casale
INTRODUCTION: Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS: A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period...
October 2016: Journal of Endourology
Marco Oderda, Giorgio Calleris, Marco Allasia, Ettore Dalmasso, Marco Falcone, Massimo Catti, Emilio Merlini, Paolo Gontero
OBJECTIVE: The aim of this study was to describe the technical aspects of a robotic pyeloplasty in pediatric patients with uretero-pelvic junction obstruction (UPJO) in horseshoe kidney (HSK) through the report of our recent case, and to outline the state of the art of minimally invasive pyeloplasty (MIP) with a systematic review of the literature. METHODS: We describe all the steps of our surgery performed on an 11-year-old patient with left UPJO in HSK in detail...
August 2, 2016: Urologia
William F Sensakovic, Matthew Cody O'Dell, Ali Agha, Raymund Woo, Laura Varich
STUDY DESIGN: Retrospective Consecutive Cohort Series OBJECTIVE.: To develop a low-dose computed tomography (CT) protocol for use in robot-assisted pediatric spinal surgery. SUMMARY OF BACKGROUND DATA: CT scans are utilized preoperatively for preoperative planning, by navigation software during robot-assisted surgery, and postoperatively to assess surgical implant placement. Traditionally high radiation doses produced by CT scanning are a concern in the highly radiosensitive pediatric population...
August 10, 2016: Spine
Daniel J Carroll, James K Byrd, George F Harris
A six-year-old boy who presented with symptoms of obstructive sleep apnea was found to have a midline tongue mass suspicious for lingual thyroglossal duct cyst (TGDC). Surgery was scheduled after workup confirmed the presence of functional, orthotopic thyroid tissue. The surgical robot was used to excise the mass endoscopically without removing any hyoid. He was extubated at the conclusion of the case. The child tolerated a soft diet and was discharged after an uneventful overnight stay in the ICU. Pathology confirmed TGDC...
September 2016: International Journal of Pediatric Otorhinolaryngology
Kentaro Mizuno, Yoshiyuki Kojima, Satoshi Kurokawa, Hideyuki Kamisawa, Hidenori Nishio, Yoshinobu Moritoki, Akihiro Nakane, Tetsuji Maruyama, Atsushi Okada, Noriyasu Kawai, Keiichi Tozawa, Kenjiro Kohri, Takahiro Yasui, Yutaro Hayashi
Robotic-assisted procedures are gaining traction as a viable form of minimally invasive surgery in the field of reconstructive surgery. In this article, the aim is to present our initial experience and clinical outcomes of robot-assisted laparoscopic pyeloplasty (RAL-P). We performed RAL-P in 22 patients for the management of ureteropelvic junction obstruction between December 2012 and August 2015. The da Vinci® S surgical system was utilized for all cases. All procedures were performed via a transperitoneal approach...
August 6, 2016: Journal of Robotic Surgery
Michael V Hollis, Patricia S Cho, Richard N Yu
The laparoscopic approach to the pyeloplasty procedure has proven to be safe and effective in the pediatric population. Multiple studies have revealed outcomes comparable to the open approach. However, a major drawback to laparoscopy is the technical challenge of precise suturing in the small working space in children. The advantages of robotic surgery when compared to conventional laparoscopy have been well established and include motion scaling, enhanced magnification, 3-dimensional stereoscopic vision, and improved instrument dexterity...
December 2015: American Journal of Robotic Surgery
Reid Hoshide, Mark Calayag, Hal S Meltzer, Michael L Levy, David D Gonda
INTRODUCTION: Endoscopic third ventriculostomy (ETV) is an established and effective treatment for obstructive hydrocephalus. In its most common application, surgeons plan their entry point and endoscope trajectory for the procedure based on anatomic landmarks, then free-handedly control the endoscope. We have introduced the Rosa robot assistance to our ETV procedure to stereotactically optimize endoscope trajectories, to reduce risk of traction on neural structures by the endoscope, and to provide a stable mechanical holder of the endoscope...
August 2016: Neurosurgery
Lauri Bishop, Andrew M Gordon, Heakyung Kim
OBJECTIVE: The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. METHODS: Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly...
July 6, 2016: American Journal of Physical Medicine & Rehabilitation
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