**Acknowledgements**

*Latest Developments in Medical Robotics Systems*

sions that we will increasingly rely on [174].

digital surgery is the next apex in surgery [175].

**11. Conclusions**

benefits in the pediatric population.

surgery.

Artificial intelligence. More sophisticated systems will track the surgeon's move-

Digital surgery (Surgery 4.0), the next frontier of surgery, is defined as the convergence of surgical technology, real-time data and artificial intelligence. Following previous waves of disruption, which saw the transition from open (Surgery 1.0) to laparoscopic surgery (Surgery 2.0), and from laparoscopic surgery to robotic surgery (Surgery 3.0), the digital paradigm in surgery is bringing unprecedented changes to the century-old field. The power of linked data and advancements in artificial intelligence are beginning to make a real impact in the way surgeries are performed, reducing well-documented variability in surgical process and outcomes. Companies, investors, surgeons and health systems are racing to accelerate the digitization of surgery in order to dramatically improve patient outcomes whilst reducing cost and inefficiencies; improve patient access; reduce inequities between populations; improve quality; and deliver more personalized surgical care, and the

Verb Surgical is building a digital surgery platform that combines robotics, advanced visualization, advanced instrumentation, data analysis, and connectivity. Surgery 4.0 or digital, which seeks to achieve less invasive and smarter interventions, "marks the beginning of a true democratization of the discipline". The Verb Surgical platform will be an option in the near future of digital surgery [175, 176].

In this chapter, in relation to robot-assisted surgery, its definition, characteristics, advantages, benefits, limitations and applications in children are addressed. As well as, the surgical areas of its application in the pediatric population, which include urological, general, thoracic, oncological and otorhinolaryngological

To date, there are multiple publications that demonstrate that robotic surgery in children is safe and effective, and it is important to offer children its benefits. However, a frequent conclusion of published studies on robotic surgery in children is the impossibility of carrying out comparative studies with all the scientific rigor, which makes it impossible to reach solid conclusions about the advantages and

Robotic surgery preferably applied to difficult and complex cases adds value to patient care, and is an important balancing factor against the apparently higher cost

The author included his results in pediatric robotic surgery, which compared to other series of similar published cases; the experience is favorable and encouraging. Globally, to date, few pediatric surgeons have adopted the robot-assisted surgery, as opposed to more pediatric urologists who have benefited more children. To

Recommendations for the implementation of a pediatric robotic surgery program are included. With robotic assistance, it is important to mention that the learning curve is shorter than with laparo-thoracoscopic surgery. It is necessary for

(main drawback), compared to open and laparo-thoracoscopic surgery.

date, in malignant tumors in children, robotic surgery has been applied less.

ments and patient data and synchronize with outcomes data to provide us with early warning systems for complications. One more interesting aspect is how these systems will participate in the surgical decision-making process in real time. We are already gathering data on tissue perfusion, helping us decide on the appropriate location for an anastomosis. Additionally, using artificial intelligence, real-time data will be collected from many sources, including electronic medical records, anesthesia monitoring systems, video images, and surgeon data for making deci-

**44**

I thank the Pediatricians, Pediatric Surgery Residents and Pediatric Surgeons of the Department of Pediatrics of the Hospital Militar de Especialidades de la Mujer y Neonatología, for their collaboration in the referral of patients for treatment with robotic surgery, and your participation in the surgical teams or as trainees. As well as, the Pediatric Surgeons of the Hospital Angeles Lomas and the Hospital Español of Mexico City, who participated in the surgical teams as trainees.
