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Robotic Surgery

Is This New Technology
Safe for Infants?

By Teri Brown

When one hears about robotic surgery, many people think of a standard robot of sci-fi lore performing surgery on a human. The thought is more than a little alarming.

Joyce Anthony from Erie, Pa., certainly thinks so. Even after doing some research on the subject and knowing that isn't true, she still has her doubts. "I have done some reading on robotic surgery, but I'm not sure I would trust such a procedure on my child," Anthony says. "There are too many variables involved ... I still prefer knowing a human is in charge when it comes to the important issues – like my child's life."

But with the newer technology, is robotic surgery the way to go when dealing with babies?

Though there are several different types of "robots" used in robotic surgery, they all basically do the same thing. After gaining access into the body, the surgeon sits at a computer console that offers a magnified, three-dimensional view of the area in which the surgery will take place. The surgeon uses special hand controls that manipulate specially designed surgical instruments.

"Robotic assisted surgery allows for the performance of complex reconstructive surgical procedures using minimally invasive approaches," says Dr. Jeffrey Stock, the director of the Division of Pediatric Urology for the Children's Hospital of New Jersey and one of the few doctors across the United States who uses the new technology to operate on infants and children. "Imagine being able to repair and sew precisely deep inside of a child's body. Until recently, you would need to make a large incision in order to get your hands to this work. The robotic technology allows this work to be done through key-hole size incisions."

Because the instruments are more dexterous than the human wrist or hands, they can turn and move in ways that were formerly impossible. This allows the surgery to be done on a much smaller and therefore less invasive scale. "Babies present a challenge when it comes to minimally invasive surgery," Dr. Stock says. "The size of the abdomen makes the need for smaller instruments critical."

Dr. Hiep Nguyen, urologist and director of Robotic Surgery and Research at Children's Hospital in Boston, agrees. "Laparoscopic surgery took off about 15 years ago and has been very successful in the adult world, but the instruments have remained too big for most pediatric procedures," Dr. Nguyen says. "Also, surgery in adults is usually to remove something, while in children we repair and reconstruct things, which requires smaller, more flexible tools."

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