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**22**

*Latest Developments in Medical Robotics Systems*

conventional laparoscopic surgery in randomized controlled trials: A systematic review and meta-analysis.

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Daskalaki D et al. Robotic liver surgery: technical aspects and review of the literature. HepatoBiliary Surg Nutr

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[13] Pamecha V, Gurusamy KS, Sharma

[14] Thakkar R, Kanwar A, Alessandri G et al. Techniques of hepatic transection in robotic surgery – is there still scope for improvement. Advanced Research in

Gastroenetrology & Hepatology.

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[46] Shen BY, Zhan Q, Deng XX, et al. Radical resection of gallbladder cancer: could it be robotic? Surg Endosc 2012;26:3245-3250

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**25**

*Robotic Liver Surgery*

2014;30(2):81-86

*DOI: http://dx.doi.org/10.5772/intechopen.99123*

[53] Wee IJY, Kuo LJ, et al. The impact of robotic colorectal surgery in obese patients: a systematic review, metaanalysis, and meta-regression. Surg Endosc. 2019 Nov;33(11):3558-3566.

[54] Wang SE, Daskalaki D, et al. Impact of Obesity on Robot-Assisted Distal Pancreatectomy. J Laparoendosc Adv Surg Tech A. 2016 Jul;26(7):551-556.

[55] Sucandy I, Attili A, et al. The impact of body mass index on perioperative outcomes after robotic liver resection. J Robot Surg. 2020 Feb;14(1):41-46.

Gynecologic Surgery. J Gynecol Surg.

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Gynecologic Surgery. J Gynecol Surg. 2014;30(2):81-86

*Latest Developments in Medical Robotics Systems*

[36] Lim C, Salloum C, Tudisco A, et al. Short- and long-term outcomes after robotic and laparoscopic liver resection for malignancies: a propensity scorematching analysis. World J Surg

[44] Li J, Tan X, Zhang X, et al. Robotic

cholangiocarcinoma: a single-centre

[45] Xu Y, Wang H, Ji W, et al. Robotic

cholangiocarcinoma: perioperative and long-term outcomes of an initial series. Surg Endosc 2016;30:3060-3070

[46] Shen BY, Zhan Q, Deng XX, et al. Radical resection of gallbladder cancer: could it be robotic? Surg Endosc

[47] Byun Y, Choi YJ, Kang JS, et al. Robotic extended cholecystectomy in gallbladder cancer. Surg Endosc

[48] Goel M, Khobragade K, Patkar S, Kanetkar A, Kurunkar S. Robotic surgery for gallbladder cancer: operative technique and early outcomes. J Surg

[49] O'Connor VV, Vuong B, et al. Robotic Minor Hepatectomy Offers a Favorable Learning Curve and May Result in Superior Perioperative

Approach. Am Surg. 2017 Oct

Haptic Feedback for Grip Force Reduction in Robotic Surgery. Sci Rep.

[51] Wottawa, Christopher R et al. "Evaluating tactile feedback in robotic surgery for potential clinical application

using an animal model." *Surgical endoscopy* vol. 30,8 (2016): 3198-3209

[52] Eddib A, Danakas A, Hughes S, et al. Influence of Morbid Obesity on Surgical Outcomes in Robotic-Assisted

1;83(10):1085-1088

2019 Mar 21;9(1):5016

Outcomes Compared with Laparoscopic

[50] Abiri A, Pensa J, et al. Multi-Modal

2020;44:887-895

2020;16:e2076

radical surgery for hilar

case series. Int J Med Robot

radical resection for hilar

2012;26:3245-3250

2020;34:3256-3261

Oncol 2019;119:958-963

matched study. World J Surg

comparison. Ann Surg Oncol

[39] Araujo RLC, Sanctis MA, Barroti LC, Coelho TRV. Robotic approach as a valid strategy to improve the access to posterosuperior hepatic segments-case series and review of

literature. J Surg Oncol 2020;121:873-80. 55.

[37] Chen PD, Wu CY, Hu RH, et al. Robotic versus open hepatectomy for hepatocellular carcinoma: a matched

[38] Guerra F, Guadagni S, Pesi B, et al. Outcomes of robotic liver resections for colorectal liver metastases. A multiinstitutional analysis of minimally invasive ultrasound-guided robotic surgery. Surg Oncol 2019;28:14-18.

[40] Dwyer RH, Scheidt MJ, Marshall JS, Tsoraides SS. Safety and efficacy of synchronous robotic surgery for

colorectal cancer with liver metastases. J

Comparison of minimally invasive and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases: a propensity score

Robot Surg 2018;12:603-6. 56

[41] Lin Q, Ye Q, Zhu D, et al.

analysis. Int J Colorectal Dis

[42] Guadagni S, Furbetta N, Di

Franco G, et al. Robotic-assisted surgery for colorectal liver metastasis: a singlecentre experience. J Minim Access Surg

[43] Beard RE, Khan S, Troisi RI, et al. Long-term and oncologic outcomes of robotic versus laparoscopic liver resection for metastatic colorectal cancer: a multicenter, propensity score

2015;30:385-395

2019;16:160-165

2019;43:1594-1603

2017;24:1021-1028

**24**

[53] Wee IJY, Kuo LJ, et al. The impact of robotic colorectal surgery in obese patients: a systematic review, metaanalysis, and meta-regression. Surg Endosc. 2019 Nov;33(11):3558-3566.

[54] Wang SE, Daskalaki D, et al. Impact of Obesity on Robot-Assisted Distal Pancreatectomy. J Laparoendosc Adv Surg Tech A. 2016 Jul;26(7):551-556.

[55] Sucandy I, Attili A, et al. The impact of body mass index on perioperative outcomes after robotic liver resection. J Robot Surg. 2020 Feb;14(1):41-46.

**27**

**Chapter 3**

**Abstract**

digital surgery.

digital surgery, children

**1. Introduction**

children.

*Mario Navarrete-Arellano*

Robotic-Assisted Minimally

Invasive Surgery in Children

Currently, minimally invasive surgery (MIS) includes conventional laparo-thoracoscopic surgery and robot-assisted surgery (RAS) or robotic surgery. Robotic surgery is performed with robotic devices, for example the Da Vinci system from Intuitive Surgical, which has a miniaturized camera capable of image magnification, a three-dimensional image of the surgical field, and the instruments are articulated with 7 degrees of freedom of movement, and the surgeon operates in a sitting position at a surgical console near the patient. Robotic surgery has gained an enormous surge in use on adults, but it has been slowly accepted for children, although it offers important advantages in complex surgeries. The areas of application of robotic surgery in the pediatric population include urological, general surgery, thoracic, oncological, and otorhinolaryngology, the largest application has been in urological surgery. There is evidence that robotic surgery in children is safe and it is important to offer its benefits. Intraoperative complications are rare, and the frequency of postoperative complications ranges from 0–15%. Recommendations for the implementation of a pediatric robotic surgery program are included. The future will be fascinating with upcoming advancements in robotic surgical systems, the use of artificial intelligence, and

**Keywords:** robot-assisted surgery, minimally invasive surgery, laparoscopy, thoracoscopy, urological, gastrointestinal, hepatobiliary, thoracic, oncological,

Pediatric robotic surgery offers unique challenges within this rapidly advancing field. There has been a slow rate of uptake within most pediatric surgical centers around the world due to both finance, and difficulties associated with equipment primarily designed for adults. The ergonomics required for the da Vinci® master–slave-type platform currently challenge the small working space in very small

Currently, there are three options for surgical treatment for a wide variety of pathologies in the pediatric population, open surgery (traditional) and MIS, which

Minimally invasive techniques are applicable in more than 60% of abdominal and thoracic operations in children, and according to evidence-based data and

include: conventional laparo-thoracoscopic surgery and RAS.

ethical principles can be used properly [1].
