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Robotic Surgery

 Center for Robotic Surgery
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Flower Innovative Treatments
Image Surgeons from the Center for Robotic Surgery at Children's Hospital Boston are pioneers in pediatric robotic surgery. More robotic surgery is performed at Children's, and it is used in a wider array of procedures, than at any other pediatric hospital in the world. Physicians work with engineers and medical device manufacturers to develop and refine the robotic equipment specifically for use in children, and they train surgeons from around the world on its use.

Cardiovascular Surgery

Cardiovascular surgeons at Children's use the robot to repair a congenital heart defect known as patent ductus arteriosus. The condition occurs when an artery designed to route blood around the lungs of the developing fetus doesn't close after birth, as it does normally. If untreated, the heart is burdened by recycling oxygenated blood that should be on its way to the rest of the body.

Traditional treatment for these conditions is major cardiac surgery requiring a large incision (several inches, depending on the age and size of the child), and a lengthy recovery. Robotic technology allows the surgeon to correct the deformity with tiny instruments placed through the chest, without the need to open the patient's ribs to reach the heart. The patient avoids a large incision and resulting scar, suffers less pain, and recovers much faster. This "closed-chest" cardiac surgery promises to revolutionize the field of cardiovascular surgery.

The department is also studying the use of robotically-assisted surgery and 3-D ultrasound to operate on the beating heart.

Today, surgeons at Children's use state-of-the-art robotic surgery equipment to divide vascular rings. This technology allows the procedure to be performed using minimally-invasive surgery techniques, which reduce pain, scarring, and recovery time.

General Surgery
General surgeons use the robot in a growing number of procedures. In older children robotic surgery is performed to correct duodenal stenosis, a partial blockage of a portion of the intestine. The technology is used during a procedure called fundoplication, which corrects gastroesophageal reflux, the backing up of stomach acids and food into the esophagus. Heller myotomy, a surgical procedure to treat achalasia, a rare disorder of the esophagus that impairs swallowing, is also performed with the robot. In very small infants the robotic surgery technology is used for lung resections and in complex reconstructions of the biliary system.
Otolaryngology
In 2005, Children's surgeons were the first to use the robotic equipment in delicate airway surgery to repair a laryngeal cleft. This rare condition creates an opening between the larynx and the esophagus and allows food and liquids to enter the lungs. Patients with laryngeal clefts suffer from chronic lung disease, swallowing difficulties, and other problems. Conventional treatment for the condition is invasive surgery requiring an incision in the neck and opening of the larynx. Children's physicians worked for two years to perfect the robotic technique required to operate through the oral cavity and in the restricted confines of the airway, without impeding breathing.
Urology
The Urology Department has been at the forefront of pediatric robotic surgery since 2001. Today, urologists perform a number of innovative procedures with the robotic equipment:

Bladder augmentation
Physicians at the Center for Robotic Surgery at Children's Hospital Boston have completed an 18-month study to perfect a method for performing complex bladder augmentations using robotically-assisted technology. The procedure involves using a portion of intestine or stomach to expand the size of very small bladders.

Pyeloplasty
This procedure is used to correct ureteropelvic junction (UPJ) obstruction, or abnormal narrowing of the ureter. Robotic surgery technology has transformed the procedure from a major abdominal surgery that left a 3" scar into one that leaves a mark smaller than ½" on the abdomen. Watch our webcast of a pyeloplasty procedure.

Renal surgeries
Traditionally, if a patient needs to have a kidney or part of it removed, a large incision is made on the flank. The robotic equipment allows more accurate surgery through a significantly smaller opening.

Ureteral reconstructions
If the ureter becomes blocked due to strictures or stones, the robotic equipment can be used to clear and repair it, avoiding the need for more invasive procedures.

Photos ©2006 Intuitive Surgical, Inc

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