Evidence map›Paper›PMID 40989820›Full record

ArticleFrontiers in pediatrics2025

Advancements and outcomes of robotic-assisted surgery in pediatric patients: a multicenter analysis.

Girolamo Mattioli, Giulia Rotondi, Stefano Avanzini, Michele Torre, Gaia Brenco, Carmelo Romeo, Francesco Molinaro, Marco Prestipino, Maurizio Cheli, Francesco Lacanna and 9 more

Abstract read
In one paragraph

Article in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Girolamo MattioliDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Giulia RotondiDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Stefano AvanziniDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Michele TorreDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Gaia BrencoDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Carmelo RomeoUnit of Pediatric Surgery, Department of Human Pathology of Adult and Childhood "Gaetano Barresi", University of Messina, Messina, Italy.
Francesco MolinaroPediatric Surgery, Department of Medical, Surgical and Neurological Sciences, S. Maria Alle Scotte Hospital, University of Siena, Siena, Italy.
Marco PrestipinoDivision of Pediatric Surgery, General Hospital of Perugia, Perugia, Italy.
Maurizio CheliDepartment of Pediatric Surgery, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
Francesco LacannaDepartment of Pediatric Surgery, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
Gabriella PaoliLigurian Regional Health Service (ALISA), Genoa, Italy.
Silvano CincottiDIME-DOGE, Università di Genova, Genova, Italy.
Chiara TombettiDIME-DOGE, Università di Genova, Genova, Italy.
Barbara RazoreDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Laura OdderaDepartment of Clinical Engineering, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Maria Beatrice DamasioDepartment of Radiology, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Andrea Michele Gino Maria WolflerDepartment of Emergency, Division of Anesthesia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Giuseppe SpigaDepartment of Planning, Control and Quality Management, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Federico PaloDepartment of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Robotic surgery (RS) has gained widespread adoption in adult surgical specialties but faces unique challenges in pediatric applications due to anatomical, technical, and economic factors. This multicenter study evaluates the feasibility, clinical outcomes, and organizational implications of implementing robotic-assisted surgery in pediatric patients across various surgical disciplines. Methods: Data were retrospectively collected from 569 pediatric patients undergoing RS between 2015 and 2016 and 2020-2025 at five Italian pediatric surgery centers. Procedures included urological, gastrointestinal, oncological, and thoracic surgeries. Patient demographics, operative details, complications, and conversion rates were analyzed. Standardized operating room setups and trocar placements were developed to optimize surgical ergonomics. Results: The median patient age was 73.8 months (range 4-575.3 months), with 9.3% weighing less than 10 kg. Urological procedures comprised 47.2% of cases, with a 0.7% conversion rate to open surgery. Gastrointestinal, oncological, and thoracic procedures had conversion rates of 3.9%, 27.2%, and 13.5%, respectively. Postoperative major complications occurred in 7% of cases. The study confirmed the safety and feasibility of RS even in patients with significant clinical complexity (20.5% ASA ≥3). Robotic technology provided enhanced precision, dexterity, and visualization, enabling complex reconstructions in confined anatomical spaces. Centralized care in dedicated pediatric centers was critical for successful implementation. Conclusions: Robotic surgery represents a significant advancement in pediatric minimally invasive surgery, offering clinical benefits across multiple specialties. Despite economic and logistical challenges, centralization and dedicated multidisciplinary teams are essential to optimize outcomes and ensure safe, sustainable adoption of robotic techniques in pediatric surgery.

Indexed as

minimally invasive surgeries (MIS)pediatric surgeryrobotic pediatric surgerysurgical outcomestechnological innovation

Identifiers

PMID40989820
PMCPMC12450917

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.