Pope John XXIII: the first two interventions performed on children with robotic surgery

The operations were carried out in collaboration with the Gaslini Hospital in Genoa, which allowed training on the robotic console by Maurizio Cheli, director of the pediatric surgical unit

Colon surgery for Hirschsprung’s disease is the first robot-assisted surgery performed at Bergamo Hospital on a pediatric patient, only 10 years old. The second operation, performed on a three-year-old girl, allowed the removal of a thoracic neoplasm. “The two operations – explains Asst. Pope John XXIII – were performed in June and July 2022. Hirschsprung’s disease, or congenital aganglionic megacolon, is a rare disease that requires a complex surgical operation in several stages, including which includes a delicate surgical removal of the terminal tract of the large intestine and rectum, devoid of nerve cells and therefore diseased. This was the stage performed for the first time in Bergamo on a ten-year-old patient with the help of the robot. In the case of the second operation, the traditional approach would have required a large surgical incision and technical difficulties. The use of the robot allowed a fast and safe, but above all radical, removal of the thoracic neoplasm, also thanks to the optical magnification (the so-called ‘magnification’) of the images that the robotic system allows. Finally only minimal surgical incisions that will not leave traces over time. An advantage from a psychological point of view for the child and his family”.

The surgical-pediatric team of Pope John, led by Maurizio Cheli, performed the two procedures under the guidance of Gaslini from Genoa, with whom there is a close mutual collaboration on digestive and hepatological surgery.

The technological innovation represented by the robot is a development of the minimally invasive surgical technique, which we are introducing as an additional option to treat some pediatric diseases and malformations for which we are a reference center – explained Cheli -. The optical magnification and the detail possibilities of the monitor with three-dimensional vision, as well as the infinite movement possibilities of the instruments, provide considerable assistance to the surgeon, which translates into greater safety for the patient. For children, the use of robots can represent an opportunity for a quick return to school and sports activities. Thanks to less extensive incisions, the postoperative course is actually less painful and faster, just as the functional recovery of the organs involved in the operation is in some cases faster”.

The robotic surgery program is planned and coordinated by Luigi Da Pozzo, professor of urology at the University of Milan Bicocca and director of the surgical department of Pope John XXIII., who makes a first half-year balance sheet: “There are 170 interventions with the robot in the first half of 2022. Taking the weekends into account, the robot usage percentage is in practice 4 interventions every 3 days. We are well beyond the regional guidelines, which set the minimum number of procedures to be performed with the robot delivered to each hospital at 250”.

The extension of the use of the robot to a multidisciplinary application continues, that is, for the treatment of pathologies belonging to different medical-surgical disciplines, in accordance with the indications in Lombardy. For years, also thanks to a period of using the robot to share and in alternating periods with another Lombard hospital, Pope John has been treated both prostate and kidney cancer with urology and some cancers of the uterus, including endometrial cancer, from Gynecology. With the arrival, in November 2020, of the new robot provided exclusively to Pope John, the operations to remove colon tumors by the abdominal and thoracic surgery 1 team were introduced. Pediatric surgery represents the program’s fourth line of development.

“Making robotic surgery available to pediatric patients allows us to offer pediatric patients the most advanced surgical techniques and to anticipate future clinical guidelines in this area,” he commented. Maria Beatrice Stasi, Director General of ASST Pope John XXIII -. Pope John is a “widespread” pediatric hospital within the Hospital for All. We have all specialties to treat pediatric patients and for the surgical area alone we perform approximately 3,700 operations per year. We recently wanted to strengthen this strategic dimension by introducing homogeneous paths dedicated to children in the company’s organizational plan presented for the Lombardy region.

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