Pediatric Robotic Surgery in Romania: Review of the First 71 Cases Using the da Vinci Platform.
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BACKGROUND: Robotic-assisted surgery has increasingly been adopted in pediatric surgical practice; however, data from early implementation stages remain limited. MATERIALS AND METHODS: We conducted a prospective audit of the first 71 pediatric robotic-assisted procedures performed over a 24-month period using the da Vinci Xi platform in a tertiary pediatric center. Patient characteristics, surgical indications, perioperative parameters, and postoperative outcomes were analyzed. RESULTS: A total of 71 procedures were performed in 71 patients (39 girls, 32 boys; mean age 4.46 years). The most frequent procedures were cholecystectomy (n = 19), ovarian tumor excision (n = 14), and pyeloplasty (n = 13). Mean operative time was 90 ± 65.30 min. Intraoperative complications occurred in 9.9% of cases, conversion to open surgery in 2.8%, and postoperative complications in 2.8%. Trocar insertion time and docking time improved significantly during the second year (p < 0.05). No mortality or long-term complications were recorded. CONCLUSIONS: Robotic-assisted pediatric surgery is feasible and safe, with acceptable complication rates and favorable early outcomes. Progressive improvement in operative setup parameters reflects a measurable learning curve.