Tech for toddlers
When children first find out that they'll be operated on with a robot, their imagination runs wild.

"They have this incredible vision of the machine coming in, walking and talking to them," says Dr. Hiep Nguyen, co-director of the Center for Robotic Surgery and director of robotic surgery research and training at Children's Hospital Boston.
Understandably, the reactions of the parents are more varied. Parents who express interest and willingness for the surgery tend to be more tech-savvy. Others are fearful of the idea that a robot will be operating on their child.

"That's why having a dedicated team like we have is very helpful. We go in and reassure [the parents] that even though [the child] is being operated on with the robot, the surgeon is still in control. There will be humans in the room with the patient at all times, and they're the ones responsible for the care," says Dr. Nguyen. "Right now clinically, robots are just an extension of the surgeon's hands and eyes. And therefore it is very, very safe. It's not like there isn't anyone in the room with the patient. There are actually more people in the room than there are during regular open surgery," he says.

Children's Hospital Boston is a pioneer of pediatric robotic procedures. In 2001, it was the first pediatric hospital to purchase a surgical robot. More recently, it became the first pediatric hospital in the world to acquire the latest model of the da Vinci Si HD Surgical System, manufactured by California-based Intuitive Surgical, Inc.

The most common pediatric surgical procedure at the hospital is a pyeloplasty or the repair of a blockage in the kidney. Before robotic surgery, this procedure required a significant open incision and intrusion through the muscle, which resulted in a lengthy recovery for kids. The surgery also involved delicate suturing, which meant that only very skilled surgeons were able to perform this complex procedure.

"Then came the robot," says Dr. Nguyen. "The three-dimensional imaging and dexterity that it provided allowed you to do very delicate suturing simply and the skill required to do this wasn't as great as conventional laparoscopy. So for us, that was a big revolution in technical development. Now we are able to perform this surgery all laparoscopically using the robot."

In addition to pyeloplasty, the surgeons at Children's Hospital Boston also perform robotic procedures such as intravical ureteral reimplantation, continent urinary diversion and bladder augmentation.

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