Monday, June 4, 2012

Children’s National Grand Rounds: Pediatric Robotic Surgery--The First Decade and New Horizons

Pioneering robotic surgery expert Craig Peters, MD, who is a Children’s National urologist and principal investigator in the Sheikh Zayed Institute, recently spoke at Children’s weekly Grand Rounds about the current and future state of surgical robotics.

Dr. Peters outlined the history of pediatric robotic surgery, which so far has focused on finding pediatric applications for the da Vinci Surgical System, the well-known current standard in robotic surgery for adults.

“Robotics in medicine was not originally conceived for use in the everyday OR,” he said. “Interestingly, these technologies were initially developed in the hopes that remote surgery could be performed in far away locations where surgeons aren’t available, like battlefields or even in space.”

Dr. Peters performs a pediatric urology procedure with the da Vinci Surgical System at Children's National.

But now, reducing complications and recovery time for patients and easing access for surgeons has become the primary focus for further development of surgical robotics. In pediatrics, usage has been relatively flat in the 10 years since Dr. Peters and his colleagues first used the da Vinci System at Boston Children’s. However, recent years have seen an increase in usage and applications as research studies conducted by Dr. Peters and others have shown the approaches are safe and effective, and more children’s hospitals acquire robots.

“Usage is gaining traction because we’ve found that it is safe and as effective as other forms of minimally invasive (laparoscopic) surgery,” he noted. “So the next question we need to answer is, ‘Is it better?’”

Children’s National recently acquired a da Vinci Surgical System with the support of the Sheikh Zayed Institute, and Dr. Peters with his multi-disciplinary team began performing pediatric robotic surgical procedures late last year.

While da Vinci is the current adult clinical standard of care, Dr. Peters sees his work with the system as more far reaching. “This system created the first digital surgery platform and created a new paradigm in terms of enhanced digital techniques. It has made these approaches part of the every day operating room, and I’m sure that the advances won’t stop here.”

Even if research finds that the da Vinci Surgical System procedures are on par with other laparoscopic approaches, Dr. Peters pointed out that, given its additional flexibility and maneuverability, it will remain an advantageous tool for procedures with difficult access points, and its contribution as proof of principle for technology use in the OR will be its real legacy.