PM1058: Robotic-assisted Surgery in Patients Less Than 15kg: A Single Center Review

Background: Robotic-assisted surgery (RAS) is an increasingly utilized tool in the armamentarium of advanced minimally invasive surgery in the pediatric population. However, specific metrics addressing the utilization of RAS among infants and small children have not been well-established in the pediatric general surgery and pediatric urology populations. The purpose of this study was to review and characterize RAS procedures for children ≤15kg.

Methods: A single institution retrospective descriptive analysis of patients < 15kg undergoing RAS between January 2013 and July 2021 was performed. Data collection included procedure type, age, weight, gender, and surgical complications. Cases were further categorized according to surgical specialty: pediatric urology (PU), pediatric surgery (PS), multiple specialties (MS). T-tests were used for statistical analyses.

Results: Since 2013, a total of 976 RAS were identified: 492 (50.4%) were performed by PU, 466 (47.8%) by PS, and 18 (1.8%) by MS (Table 1). One hundred and eighteen (12.1%) RAS were performed on children < 15kg, consisting of 110 (93.2%) PU cases, 6 (5.1%) PS cases, and 2 (1.7%) MS cases. Procedures amongst smaller patients were significantly more common in the PU subgroup, mean 12 cases/year, compared to PS subgroup, mean 0.63 cases/year, (p < 0.01). The mean weight of PU patients (10.5kg) was significantly less than PS patients (13.9kg) (p < 0.01). Mean age was also significantly lower among PU patients (18.6 months) compared to PS (34.2 months) (p < 0.01).

Conclusion: RAS among patients ≤15kg is safe and feasible across pediatric surgical subspecialties. RAS was performed more frequently by pediatric urologists in younger and smaller patients compared to pediatric surgeons. Further refinement of robotic technology and instrumentation should enhance the applicability of these procedures in this young group.