Robotic surgery for children

Seven's On Call with Dr. Jay Adlersberg
October 27, 2008 4:08:10 PM PDT
Robotic surgery is the latest and greatest tool in the operating room. In many cases it means smaller incisions and quicker recovery times, but until recently it was primarily used for adults.

Now, robotic arms are working their surgical magic on a new set of smaller patients -- now helping doctors save children's lives.

"It happened on Thanksgiving. It happened on her birthday. On Christmas," Martha Umana said.

Some of the best of days in the Umana household turned into the worst.

"Her fever would go up to 105 and she would just go into a seizure," she said.

Kaila Umana suffered from a condition called hydronephrosis -- an obstruction of the urinary track, which can cause chronic kidney infections. The only cure is surgery. Luckily, a robot named the da Vinci helped doctors operate more precisely and less invasively on Kaila's tiny body. They move the robot's arms with a controller, using a telescopic lens as a guide.

"We would require about a five-inch incision in the abdomen. Now the surgery is done using two small incisions about a dime each in size and one small incision in the belly button," said Dr. Waldo Feng, pediatric urology surgeon at Snurise Children's Hospital.

The robotic surgery means children go home with their parents sooner.

"It was like the best thing because she was only in the hospital about two days," Umana said.

Children as young as five-months-old have successfully undergone robotic surgery. the da vinci is also used to operate on children's kidneys, esophagus and lungs. with a quicker recovery, kaila is back to what's important -- being a kid.

Researchers are working to develop robots that can operate on a beating heart, correct problems while a baby is still in utero and delicately perform precise brain surgeries in areas where a surgeon's tools can't fit.

Traditionally, laparoscopic (or minimally invasive) procedures were only used to treat a limited number of problems because of limitations faced by surgeons. Using the da Vinci robot, more surgeons can perform a wider array of operations laparoscopically using a one to two cm incision. To date, the da Vinci has been used in the operating room for everything from minimally invasive heart surgery to minimally invasive cancer surgery, and also to treat conditions as such as prostate cancer, endometrial cancer, morbid obesity and mitral valve regurgitation.

Some of the benefits of using the da Vinci robot include the following: Reduced trauma to the body
Reduced blood loss and need for transfusions
Less post-operative pain and discomfort
Less risk of infection
Shorter hospital stay
Faster recovery and return to normal daily activities
Less scarring and improved cosmetics

HOW IT WORKS: The da Vinci robot consists of an ergonomically designed surgeon's console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist Instruments. State-of-the-art robotic technology powers the system and allows for the surgeon's hand movements to be scaled, filtered and seamlessly translated into precise movements of the EndoWrist Instruments. The System cannot be programmed, nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from a surgeon.

DA VINCI FOR KIDS: Initially, da Vinci robotic surgery was only available to adults because it was thought that the robot was too bulky for operating on children; but, it turns out the delicate robotic movements are ideal for the reconstructive surgeries children require. So far, the robot has been used to fix many types of birth defects in children and is used to remove poorly functioning or cancerous organs. The areas of pediatric surgery, urology, cardiothoracic surgery, and neurosurgery have embraced the robotic technology. Children as young as five months old and as small as 20 pounds have successfully undergone robotic surgery.

FOR MORE INFORMATION:

http://www.sunrisechildrenshospital.com
http://davincisurgery.com

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