Robot-Assisted Surgery at Nationwide Children's
Like procedures that utilize minimally invasive approaches, robot-assisted surgery involves making a series of small incisions. Using the da Vinci® Surgical System, trained surgeons insert robotic instruments which are controlled with their own movements. The equipment uses advanced imaging technology so the surgeon can perform highly complex movements with enhanced precision and visualization over traditional techniques. The robotic instruments are highly maneuverable compared to non-robotic instruments. The robotic system includes an advanced camera that allows surgeons to monitor their movements using high-definition 3D digital imaging. This improves the surgeon’s ability to visualize the patient’s anatomy. Remote viewing allows other members of the surgical team to observe the procedure in real time. This helps Nationwide Children’s Hospital to train the next generation of pediatric surgeons and pediatric urologists.
Pediatric Urology
Robot-assisted technology is used in many surgical specialties, especially Pediatric Urology. Many urological procedures, like pyeloplasty, ureteral reimplantation and bladder reconstruction, are well suited to this type of advanced surgical technology and provide patients with an effective minimally invasive option. The urology team at Nationwide Children’s offers a wide breadth of experience. Your child will have access to health providers who are experts in different types of medical care and who are trained in robotic surgery to treat complex pelvic reconstruction cases.
Pediatric Metabolic and Bariatric Surgery
The metabolic and bariatric surgery program at Nationwide Children's was the first free-standing pediatric bariatric surgery center in the U.S. to be accredited by the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Nationwide Children’s was one of the first pediatric centers in the country to use robotic surgery for patients with the most severe forms of obesity.
Complex Colorectal and Pelvic Reconstructive Surgery
As ways to use the robot continue to expand, Nationwide Children’s has been on the forefront of applying this technology into complex pelvic reconstruction in patients with anorectal malformation. Our Center for Colorectal and Pelvic Reconstruction combines the expertise of our pediatric colorectal surgeons with urology surgeons to deliver minimally invasive surgical care during these complex procedures. We have done many reconstructive procedures to help patients achieve bladder and bowel control. We also are one of the few centers to use the robot in the initial repair of cloacal malformations.
Pediatric General and Thoracic Surgery
While robotic technology has been a mainstay of minimally invasive approach in pediatric urology for well over a decade, its use in pediatric surgery is a more recent development. Since its formation in 2012, the robotic team at Nationwide Children’s has been at the forefront of this emerging field. We are the busiest pediatric center in the U.S. to offer patients this advanced surgical option. With the upgrade of the da Vinci Xi system in 2020, the pediatric surgery team routinely performs a number of complex robotic-assisted cases including fundoplication, hiatal hernia repair, cholecystectomy, splenectomy, inguinal hernia repair, median arcuate ligament (MALS) release, paraspinal and mediastinal mass removals, adrenalectomy, and other surgical oncology procedures.
Benefits of Robotic Surgery
Robot-assisted and other minimally invasive procedures offer many benefits, compared to traditional “open” procedures. These often include:
- Smaller incisions
- Reduced blood loss
- Shorter hospital stays
- Less pain for the patient after surgery, and less pain medication
- Faster recovery
- Reduced risk of infection and complications
- Fewer scars
- Increased patient and family satisfaction
Compared to standard laparoscopic procedures, robot-assisted surgery is less invasive. Robotic technology dramatically expands the surgeon’s natural abilities. Key advantages include:
- Greater dexterity: The surgeon directs the instruments with a higher degree of dexterity and range of motion, far greater than the human hand can accomplish on its own.
- Enhanced precision: Robotic technology allows for highly precise movements, including adjustable motion-scaling. It also eliminates the natural tremor of the human hand, which can be invisible to the unaided eye, but noticeable under high magnification.
- Improved visualization: High-definition monitoring offers an unprecedented level of stable viewing at extreme magnification. The da Vinci® surgical system also provides three-dimensional visualization, giving surgeons depth perception to guide them during delicate procedures.
A Good Candidate for Robotic Surgery
Ultimately, the decision to use robotic surgery and other minimally invasive techniques will be decided between you and your surgeon. There are several factors that make a child more likely to benefit from robotic surgery, including:
- A thorough review of other care from your primary care doctor or lead attending physician
- When open surgery has been recommended as the best next step
- No or little history of tobacco use
- A need for faster recovery to return to current lifestyle
- Concerns about narcotics that may be needed for traditional open surgery
Procedures
- Fundoplication
- Hiatal hernia repair
- Cholecystectomy
- Splenectomy
- Inguinal hernia repair
- Chest wall
- Mediastinal and paraspinal mass removals
- Gastric sleeve surgery
- Gastric bypass
- Laparoscopic adjustable band
- Appendicocecostomy diversion (Malone antegrade continence enema (MACE) procedure)
- Appendicovesicostomy (Mitrofanoff)
- Bladder neck reconstruction and bladder neck sling
- Bladder augmentation
- Kidney reconstruction, including partial nephrectomy
- Pyeloplasty: ureteropelvic junction obstruction surgery
- Ureter reconstruction
- Ureteral reimplantation: vesicoureteral reflux (VUR) surgery