Robotic-assisted minimally invasive surgery (RA-MIS) for tumor resection is an emerging technology in the pediatric population with significant promise but unproven safety and feasibility. A multi-center retrospective review of patients ≤18 years undergoing RA-MIS tumor resection from December 2015–March 2023 was performed. Patient demographics, perioperative variables, and complication rates were analyzed. Thirty-nine procedures were performed on 38 patients (17 thoracic, 22 abdominal); 37% female and 68% non-Hispanic White. Median age at surgery was 8.3 years (IQR 5.7, 15.7); the youngest was 1.7 years-old. Thoracic operations included resections of neuroblastic tumors (n = 16) and a single paraganglioma. The most common abdominal operations included resections of neuroblastic tumors (n = 5), pheochromocytomas (n = 3), and angiomyolipomas (n = 3). Six patients underwent retroperitoneal lymph node dissection (RPLND) for paratesticular tumors. Median operating time for the cohort was 2:52 h (IQR 2:04, 4:31). Two thoracic cases required open conversion due to poor visualization and lack of working domain. All patients underwent complete tumor resection; one had tumor spillage from a positive margin (Wilms tumor). Median LOS was 1.5 days (IQR 1.1, 3.0). Postoperatively, one patient developed a chyle leak requiring interventional radiology drainage, but none required a return to the operating room. Robotic-assisted surgery is safe and feasible for tumor resection in carefully selected pediatric patients, achieving complete resection with minimal morbidity and short LOS. Resection should be performed by those with robotic expertise for optimal outcomes. IV. Original Clinical Research.

中文翻译：

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机器人辅助小儿胸腹部肿瘤切除术：初步多中心审查

用于肿瘤切除的机器人辅助微创手术（RA-MIS）是儿科人群中的一项新兴技术，具有巨大的前景，但安全性和可行性尚未得到证实。对 2015 年 12 月至 2023 年 3 月期间接受 RA-MIS 肿瘤切除术的 ≤18 岁患者进行了多中心回顾性研究。分析了患者人口统计学、围手术期变量和并发症发生率。对 38 名患者进行了 39 次手术（17 名胸部手术，22 名腹部手术）； 37% 为女性，68% 为非西班牙裔白人。手术时的中位年龄为 8.3 岁（IQR 5.7, 15.7）；最小的1.7岁。胸部手术包括切除神经母细胞肿瘤（n = 16）和单个副神经节瘤。最常见的腹部手术包括神经母细胞肿瘤切除术 (n = 5)、嗜铬细胞瘤切除术 (n = 3) 和血管平滑肌脂肪瘤切除术 (n = 3)。六名患者因睾丸旁肿瘤接受了腹膜后淋巴结清扫术（RPLND）。该队列的中位手术时间为 2:52 小时（IQR 2:04、4:31）。由于可视化较差且缺乏工作区域，两个胸部病例需要进行开放式转换。所有患者均接受肿瘤完整切除；一种是肿瘤从阳性切缘溢出（Wilms 肿瘤）。中位 LOS 为 1.5 天（IQR 1.1、3.0）。术后，一名患者出现乳糜漏，需要介入放射引流，但没有人需要返回手术室。机器人辅助手术对于精心挑选的儿科患者进行肿瘤切除是安全可行的，可以实现完全切除，发病率最低，LOS短。切除术应由具有机器人专业知识的人员进行，以获得最佳结果。四．原创临床研究。