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.pdf
Matthew P. Lungren
Michael R.B. Evans
Editors
Clinical Medicine
Pediatric Robotic
Covertemplate
Surgery
Subtitle for
Qiang Shu
Clinical Medicine Covers T3_HB
Editor
Second Edition
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123
Pediatric Robotic Surgery
Qiang Shu
https://t.me/medicina_free
Editor
Pediatric Robotic
Surgery
Editor
https://t.me/medicina_free
Qiang Shu
Cardiac Surgery
Children’s Hospital
Zhejiang University School of Medicine
Hangzhou, China
ISBN 978-981-19-9692-4 ISBN 978-981-19-9693-1 (eBook)
https://doi.org/10.1007/978-981-19-9693-1
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Singapore Pte Ltd. 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of reprinting, reuse
of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical
way, and transmission or information storage and retrieval, electronic adaptation, computer
software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore
189721, Singapore
Preface 1
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As a state-of-the-art intelligent minimally invasive technology, the da Vinci
surgical system (DVSS) has made a giant leap forward in terms of software
and hardware innovations, compared with the traditional laparoscopic technique. Although robotic surgery has been widely used in adult surgery, the
use of robotic surgery in the eld of pediatric surgery is relatively lagging
behind. Recent years have witnessed an increasing number of DVSS installed
in pediatric hospitals, which is a clear indication that robotic surgery has been
more widely used in pediatric surgery. The combined use of DVSS and traditional laparoscopic techniques has demonstrated advantages in the treatment
of pediatric surgical diseases, including the treatment of related diseases in
various departments of pediatric surgery.
This book falls into ve parts. The rst part is about the related equipment
and installments of DVSS operating room; the second part is about the cooperation of DVSS’s professional nurses during operation; the third part is
about the specic procedures and attentions of anesthesiologists before, during, and after DVSS operation; the fourth part is about the standardized resident doctor training of DVSS operation; and the fth part is about the
introduction and operation description of various diseases from all pediatric
departments suitable for DVSS operation; among these are pediatric general
surgery (choledochal cyst radical mastectomy, Hirschsprung’s disease, spleen
and partial splenectomy, mesenteric cyst, Meckel’s diverticulum), neonatal
surgery (anoplasty, annular pancreatoduodenal anastomosis, intestinal malrotation correction), cardiothoracic surgery (lobectomy and segmentectomy,
esophagoplasty, fundoplication, diaphragmatic plication, patent ductus arteriosus ligation), oncology surgery (ovarian cystectomy, adrenal tumor resection), and urology (pyeloplasty, ureteral bladder reimplantation, ureteral
anastomosis, kidney and partial nephrectomy, prostatectomy).
The rst four parts are introduced to the surgery textbook for the rst time.
These contents are written in plain language with practical purposes, combined with illustrations in an easy-to-read manner. The fth part is based on
each disease. It elaborates the diagnosis, surgical indications, and surgical
procedures for each disease and systematically describes different parts of the
surgical technology with real diagrams, which contributes to the prevention
and treatment of intraoperative and postoperative complications. It is also
companioned with a complete surgery video, which is benecial to medical
students and young pediatric surgeons. By reading this book, team cooperation in surgery will be further improved, so that everyone knows what to do
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next. The assistant will be familiar with the operation steps, knowing how to
cooperate with the surgeon, and the nurse can accurately provide instruments
and sutures in time. It is also of high reference value for building a da Vinci’s
operating room team in your hospital.
Nowadays, the living standards of the whole people have signicantly
improved, while the well-being of children demands even higher levels. Thus,
pediatric surgery requires reasonable standardization. This book, by improving and perfecting the standardization of pediatric da Vinci surgery, provides
reference templates and lays foundation for pediatric surgery in times to
come.
Shusen Zheng, MD
Academician of China Academy of Engineering
Division of Hepatobiliary Pancreatic Surgery,
Shulan (Hangzhou) Hospital, Zhejiang Shuren University
School of Medicine; NHC Key Laboratory of Combined
Multi-organ Transplantation, China; Key Laboratory
of the diagnosis and treatment of organ Transplantation,
Research Unit of Collaborative Diagnosis and Treatment
for Hepatobiliary and Pancreatic Cancer, Chinese
Academy of Medical Sciences (2019RU019), China;
Key Laboratory of Organ Transplantation, Research Center
for Diagnosis and Treatment of Hepatobiliary Diseases,
Hangzhou 310003, China
Preface 1
Preface 2
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With the rapid evolution of surgical robot technology, the da Vinci robotic
surgical system has been upgraded to the Xi. Along with the design of robotic
surgical instruments becoming more suitable for pediatric patients and a
deeper understanding of complex diseases in pediatric surgery, superiorities
of robotic surgery for complex pediatric surgical diseases are being increasingly highlighted. The doubts about the contradiction between robotic surgical instruments and the limited surgical space of children are also diminishing,
and a revolution in pediatric robotic surgery is quietly underway.
In 2002, the rst case of pediatric robotic-assisted pyeloplasty was reported
in the United States. Since then, robotic surgery has made signicant progress in the eld of pediatric urology. However, the application of roboticassisted surgery in pediatric general surgery, pediatric cardiothoracic surgery,
neonatal surgery, and pediatric oncology surgery has not reached the same
level as its application in pediatric urology. Dr. Qiang Shu, the editor of this
book, has led the surgical team at Children’s Hospital, Zhejiang University
School of Medicine, to systematically evaluate the safety, feasibility, and
future applications of robotic surgery in the eld of pediatric surgery. They
innovatively developed mechanical system layout techniques and a series of
surgical procedures, achieving comprehensive coverage of robotic surgery
for pediatric diseases in six major systems: general surgery, oncology, neonatal surgery, cardiac surgery, thoracic surgery, and urology. They have also
developed a day surgery program for pediatric robotic surgery. While advancing their own team’s development, Children’s Hospital, Zhejiang University
School of Medicine, has established the Chinese da Vinci Robot Pediatric
Surgery Clinical Training and Demonstration Center, which provides a highlevel platform for training Chinese robotic surgery experts. Dr. Shu’s surgical
team has achieved a series of major innovative and revolutionary breakthroughs in pediatric robotic surgery, including various disease types, youngest age, lowest weight, etc. Based on their own experiences, the team nally
published this academic monograph on pediatric robotic surgery, which will
provide a practical and in-depth guidance to more pediatric surgeons worldwide and promote the development of robotic surgery in pediatric surgery.
This book is an extremely practical and highly specialized book on pediatric robotic surgery, with comprehensive and in-depth contents, concise
structures, and clear key points, accompanied by rich illustrations. The book
starts with the current development status of pediatric robotic surgery, the
basic principles and technology of robotic systems, the construction of
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robotic operating rooms, and the qualication training for pediatric surgeons.
It then provides in-depth descriptions of specic surgical procedures, indications and contraindications, and complications in the six major systems of
diseases, providing readers with knowledge and insights in multiple elds.
The book also provides schematic diagrams of the surgical procedures and
actual surgical case photos and videos, making the whole surgical process
visually displayed to the readers.
The publication of this book is a milestone in the eld of pediatric robotic
surgery. I believe it will become a landmark literature in pediatric robotic
surgery, which provides rich and valuable resources for medical practitioners,
researchers, and students. On the eve of the publication of this book, I am
honored to be invited to write the foreword. While reading it, I have felt Dr.
Shu and his team’s dedicated pursuits and diligent efforts in professional and
excellent surgical skills. Finally, I hope this book will inspire more research
and innovation in robotic surgery, cultivate more pediatric robotic surgical
teams, and then contribute to the promotion for children’s well-being.
Xu Zhang
Academician of Chinese Academy of Sciences;
Director of the Academy of Urology,
Chinese PLA General Hospital, Beijing, China.
Preface 2
Contents
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1 Robotic-assisted Surgery in Pediatrics: Current Applications,
Limitations and Prospects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Qiang Shu
2 Introduction of Robot-assisted Surgical Technology: the da Vinci
Xi System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Kun Zheng and Zhongkuan Lin
3 Robotic Operating Room Configuration . . . . . . . . . . . . . . . . . . . 17
Hang Yan Zhao and Chunyan Zhan
4 Pediatric Anesthesia for Robotic Surgery in Children . . . . . . . . 21
Jinjin Huang and Yaoqin Hu
5 Robotic Resident and Fellow Training . . . . . . . . . . . . . . . . . . . . . 29
Qiang Shu and ZongWei Huang
6 Robotic-Assisted Esophagoplasty for Congenital
Esophageal Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Shaotao Tang and Liang Liang
7 Robotic-Assisted Pulmonary Lobectomy . . . . . . . . . . . . . . . . . . . 41
Qiang Shu and Zheng Tan
8 Robotic-Assisted Segmentectomy . . . . . . . . . . . . . . . . . . . . . . . . . 47
Qiang Shu and Zheng Tan
9 Robot-Assisted Laparoscopic Repair of Hital Hernia . . . . . . . . . 53
Jiangeng Yu and Yue Gao
10 Robotic-Assisted Plication of Diaphragmatic Eventration . . . . . 61
Zheng Tan and Ting Huang
11 Robotic-Assisted Ligation of The Patent Ductus Arteriosus . . . . 67
Liyang Ying and Xiwang Liu
12 Robotic-Assisted Congenital Choledochal Cyst
Radical Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Zhigang Gao and Duote Cai
13 Robotic-Assisted Splenectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Zhigang Gao and Yuebin Zhang
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14 Robotic-assisted Partial Splenectomy . . . . . . . . . . . . . . . . . . . . . . 95
Zhigang Gao and Yuebin Zhang
15 Robotic-Assisted Mesenteric Cyst Resection . . . . . . . . . . . . . . . . 103
Zhigang Gao and Di Hu
16 Robotic System Assisted Soave Procedure for Hirschsprung
Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Qingjiang Chen and Wenjuan Luo
17 Robotic-Assisted Anorectoplasty for Congenital Anorectal
Malformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Jinfa Tou and Dengming Lai
18 Robotic-Assisted Duodenoduodenostomy for Duodenal
Stenosis and Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Qingjiang Chen and Ken Chen
19 Robotic-Assisted Ladd’s Procedure for Congenital
Malrotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Jinfa Tou and Shoujiang Huang
20 Robotic-Assisted Duodenal Anastomosis for Annular
Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Jinfa Tou and Chengjie Lv
Contents
21 Robotic-Assisted Intestinal Duplication Resection . . . . . . . . . . . 141
Zhigang Gao and Yi Jin
22 Robotic-Assisted Partial Nephrectomy for Duplicated
System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Chang Tao and Long Sun
23 Robotic-Assisted Nephrectomy for Dysplasia Kidney . . . . . . . . . 155
Chang Tao and Long Sun
24 Robotic-Assisted Pyeloplasty for Ureteropelopic
Junction Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Chang Tao and Huixia Zhou
25 Robot-Assisted Ureterovesical Replantation . . . . . . . . . . . . . . . . 167
Guangjie Chen and Huixia Zhou
26 Robotic-Assisted Prostatic Cystectomy and Seminal
Reconstruction for Prostatic Utricle Cyst . . . . . . . . . . . . . . . . . . . 173
Chang Tao and Zheming Xu
27 Robot-Assisted Ureteroureterostomy for Duplicated
Kidneys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Guangjie Chen and Huixia Zhou
28 Robotic-Assisted Adrenal Tumor Resection . . . . . . . . . . . . . . . . . 185
Jinhu Wang and Jiabing Cai
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