{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:50:21Z","timestamp":1785790221826,"version":"3.56.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Describe the implementation of robotic-assisted surgery for pediatric cysts and neoplasms and characterize perioperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of pediatric patients undergoing robotic-assisted resection of cysts or neoplasms at a quaternary children\u2019s hospital from 2011 to 2026. Demographic, lesion, operative, and outcome data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-eight pediatric robotic cases were reviewed. Median age was 13 years (IQR 8.25\u201316). Eighteen intracavitary cysts and 20 neoplasms were resected. Operations for solid neoplasms consisted of thymectomies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), mediastinal teratoma excision, lung lobectomy, partial gastrectomy, left hepatectomy, distal pancreatectomy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), pancreatic uncinate resection, pancreaticoduodenectomy, nephrectomies (2 partial, 2 radical), adrenalectomy, periadrenal mass resection, ovarian cystectomy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), and radical cystoprostatectomy. Median EBL was 15 mL (IQR 5\u201325) and day of discharge 1 (IQR 0\u20132). The median opioid dose prescribed at discharge was 0.28\u00a0mg\/kg oral morphine equivalents with duration of 1 (0\u20133) day. Thirty-one (82%) patients experienced no complications. Major complications occurred after pancreatic resections, including hemorrhagic pancreatitis following uncinate resection and delayed biliary stenosis with ductal leak after pancreaticoduodenectomy requiring revision 1.5 years later.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic-assisted surgery is a safe and feasible option for selected pediatric cysts and neoplasms, offering low blood loss, short hospitalization, and minimal postoperative opioid requirements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06560-x","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T07:09:38Z","timestamp":1785740978000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic-assisted resection of pediatric intracavitary lesions: expanding the boundaries of minimally invasive surgery"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0408-0830","authenticated-orcid":false,"given":"Alejandro O.","family":"Chara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas S.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan J.","family":"D\u2019Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Stout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Frainey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Corona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglass B.","family":"Clayton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold N.","family":"Lovvorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irving J.","family":"Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"6560_CR1","doi-asserted-by":"publisher","unstructured":"Phelps HM, Lovvorn HN (2018) Minimally invasive surgery in pediatric surgical oncology. Children 5:15 https:\/\/doi.org\/10.3390\/children5120158","DOI":"10.3390\/children5120158"},{"key":"6560_CR2","doi-asserted-by":"publisher","first-page":"150864","DOI":"10.1016\/j.sempedsurg.2019.150864","volume":"28","author":"D von Allmen","year":"2019","unstructured":"von Allmen D (2019) Pediatric surgical oncology: a brief overview of where we have been and the challenges we face. Semin Pediatr Surg 28:150864. https:\/\/doi.org\/10.1016\/j.sempedsurg.2019.150864","journal-title":"Semin Pediatr Surg"},{"key":"6560_CR3","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1245\/s10434-021-10777-6","volume":"29","author":"T Blanc","year":"2022","unstructured":"Blanc T, Meignan P, Vinit N, Ballouhey Q, Pio L, Capito C, Harte C, Vatta F, Galmiche-Rolland L, Minard V, Orbach D, Berteloot L, Muller C, Kohaut J, Broch A, Braik K, Binet A, Heloury Y, Fourcade L, Lardy H, Sarnacki S (2022) Robotic surgery in pediatric oncology: lessons learned from the first 100 tumors: a nationwide experience. Ann Surg Oncol 29:1315\u20131326. https:\/\/doi.org\/10.1245\/s10434-021-10777-6","journal-title":"Ann Surg Oncol"},{"key":"6560_CR4","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1002\/pbc.24154","volume":"59","author":"SW Warmann","year":"2012","unstructured":"Warmann SW, Seitz G, Fuchs J (2012) Surgical complications in pediatric surgical oncology. Pediatr Blood Cancer 59:398\u2013404. https:\/\/doi.org\/10.1002\/pbc.24154","journal-title":"Pediatr Blood Cancer"},{"key":"6560_CR5","doi-asserted-by":"crossref","unstructured":"Holcomb GW, Tomita SS, Haase GM, Dillon PW, Newman KD, Applebaum H, Wiener ES (1995) Minimally invasive surgery in children with cancer. Cancer 76:121\u2013128. https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/1097-0142%2819950701%2976%3A1%3C121%3A%3AAID-CNCR2820760119%3E3.0.CO%3B2-%23","DOI":"10.1002\/1097-0142(19950701)76:1<121::AID-CNCR2820760119>3.0.CO;2-#"},{"key":"6560_CR6","doi-asserted-by":"publisher","first-page":"e5181","DOI":"10.1097\/MD.0000000000005181","volume":"95","author":"C Oh","year":"2016","unstructured":"Oh C, Youn JK, Han J-W, Kim H-Y, Jung S-E (2016) Abdominal tumors in children: comparison between minimally invasive surgery and traditional open surgery. Medicine (Baltim) 95:e5181. https:\/\/doi.org\/10.1097\/MD.0000000000005181","journal-title":"Medicine (Baltim)"},{"key":"6560_CR7","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1089\/lap.2018.0467","volume":"29","author":"A Abdelhafeez","year":"2019","unstructured":"Abdelhafeez A, Ortega-Laureano L, Murphy AJ, Davidoff AM, Fernandez-Pineda I, Sandoval JA (2019) Minimally invasive surgery in pediatric surgical oncology: practice evolution at a contemporary single-center institution and a guideline proposal for a randomized controlled study. J Laparoendosc Adv Surg Tech A 29:1046\u20131051. https:\/\/doi.org\/10.1089\/lap.2018.0467","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"6560_CR8","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1542\/peds.2008-3822","volume":"124","author":"G van Haasteren","year":"2009","unstructured":"van Haasteren G, Levine S, Hayes W (2009) Pediatric robotic surgery: early assessment. Pediatrics 124:1642\u20131649. https:\/\/doi.org\/10.1542\/peds.2008-3822","journal-title":"Pediatrics"},{"key":"6560_CR9","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1089\/lap.2015.0119","volume":"25","author":"F Friedmacher","year":"2015","unstructured":"Friedmacher F, Till H (2015) Robotic-assisted procedures in pediatric surgery: a critical appraisal of the current best evidence in comparison to conventional minimally invasive surgery. J Laparoendosc Adv Surg Tech A 25:936\u2013943. https:\/\/doi.org\/10.1089\/lap.2015.0119","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"6560_CR10","doi-asserted-by":"publisher","first-page":"151263","DOI":"10.1016\/j.sempedsurg.2023.151263","volume":"32","author":"JC Jacobson","year":"2023","unstructured":"Jacobson JC, Scrushy MG, Gillory LA, Pandya SR (2023) Utilization of robotics in pediatric surgical oncology. Semin Pediatr Surg 32:151263. https:\/\/doi.org\/10.1016\/j.sempedsurg.2023.151263","journal-title":"Semin Pediatr Surg"},{"key":"6560_CR11","doi-asserted-by":"publisher","first-page":"109616","DOI":"10.1016\/j.surg.2025.109616","volume":"187","author":"S Chang","year":"2025","unstructured":"Chang S, Feng J, Cheng Y, Yang S, Ren Q, Cheng H, Chang X, Zhu Z, Han J, Yang W, Qin H, Wang H (2025) Robot-assisted surgery for pediatric tumors: a single-center study of 114 cases. Surgery 187:109616. https:\/\/doi.org\/10.1016\/j.surg.2025.109616","journal-title":"Surgery"},{"key":"6560_CR12","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1016\/j.jpedsurg.2024.02.021","volume":"59","author":"WJ Svetanoff","year":"2024","unstructured":"Svetanoff WJ, Carter M, Diefenbach KA, Michalsky M, DaJusta D, Gong E, Lautz TB, Aldrink JH (2024) Robotic-assisted pediatric thoracic and abdominal tumor resection: an initial multi-center review. J Pediatr Surg 59:1619\u20131625. https:\/\/doi.org\/10.1016\/j.jpedsurg.2024.02.021","journal-title":"J Pediatr Surg"},{"key":"6560_CR13","doi-asserted-by":"publisher","first-page":"CD008403","DOI":"10.1002\/14651858.CD008403.pub3","volume":"1","author":"EC van Dalen","year":"2015","unstructured":"van Dalen EC, de Lijster MS, Leijssen LG, Michiels EM, Kremer LC, Caron HN, Aronson DC (2015) Minimally invasive surgery versus open surgery for the treatment of solid abdominal and thoracic neoplasms in children. Cochrane Database Syst Rev 1:CD008403. https:\/\/doi.org\/10.1002\/14651858.CD008403.pub3","journal-title":"Cochrane Database Syst Rev"},{"key":"6560_CR14","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1177\/00031348211070796","volume":"88","author":"KG McKay","year":"2022","unstructured":"McKay KG, Abdul Ghani MO, Crane GL, Evans PT, Zhao S, Martin LY, Thomas JC, Correa H, Benedetti DJ, Lovvorn HN (2022) Oncologic fidelity of minimally invasive surgery to resect neoadjuvant-treated wilms tumors. Am Surg 88:943\u2013952. https:\/\/doi.org\/10.1177\/00031348211070796","journal-title":"Am Surg"},{"key":"6560_CR15","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1177\/00031348221093802","volume":"88","author":"KG McKay","year":"2022","unstructured":"McKay KG, Hanna DN, Martin L, Datye KA, Crane GL, Correa H, LovvornIII HN, Solorzano CC, Zamora IJ (2022) Intraoperative ultrasound guided laparoscopic spleen-preserving distal pancreatectomy for primitive neuroendocrine tumors in a pediatric patient with MEN-1. Am Surg 88:2241\u20132243. https:\/\/doi.org\/10.1177\/00031348221093802","journal-title":"Am Surg"},{"key":"6560_CR16","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1053\/j.ro.2011.07.004","volume":"47","author":"GL Crane","year":"2012","unstructured":"Crane GL, Hernanz-Schulman M (2012) Current imaging assessment of congenital abdominal masses in pediatric patients. Semin Roentgenol 47:32\u201344. https:\/\/doi.org\/10.1053\/j.ro.2011.07.004","journal-title":"Semin Roentgenol"},{"key":"6560_CR17","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jss.2019.05.059","volume":"243","author":"HM Phelps","year":"2019","unstructured":"Phelps HM, Robinson JR, Chen H, Luckett TR, Conroy PC, Gillis LA, Hays SR, Lovvorn HN (2019) Enhancing recovery after kasai portoenterostomy with epidural analgesia. J Surg Res 243:354\u2013362. https:\/\/doi.org\/10.1016\/j.jss.2019.05.059","journal-title":"J Surg Res"},{"key":"6560_CR18","doi-asserted-by":"publisher","first-page":"151255","DOI":"10.1016\/j.sempedsurg.2023.151255","volume":"32","author":"JC Jacobson","year":"2023","unstructured":"Jacobson JC, Pandya SR (2023) Pediatric robotic surgery: an overview. Semin Pediatr Surg 32:151255. https:\/\/doi.org\/10.1016\/j.sempedsurg.2023.151255","journal-title":"Semin Pediatr Surg"},{"key":"6560_CR19","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s00383-025-06018-6","volume":"41","author":"L Pio","year":"2025","unstructured":"Pio L, Bruno T, Godzinski J, Ehrlich PF, Cost N, Davidoff AM, Irtan S, Pachl M, Abu-Zaid A, Abdelhafeez AH, Losty PD (2025) Comparison of open and minimally invasive nephrectomy for Wilms tumor: a systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology. Pediatr Surg Int 41:117. https:\/\/doi.org\/10.1007\/s00383-025-06018-6","journal-title":"Pediatr Surg Int"},{"key":"6560_CR20","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s00464-025-12429-2","volume":"40","author":"C Delgado-Miguel","year":"2026","unstructured":"Delgado-Miguel C, Camps J, Garavis Montagut I, Arredondo-Montero J, Hern\u00e1ndez-Oliveros F (2026) Robotic-assisted surgery in children under 10 kg: a systematic review. Surg Endosc 40:40\u201358. https:\/\/doi.org\/10.1007\/s00464-025-12429-2","journal-title":"Surg Endosc"},{"key":"6560_CR21","doi-asserted-by":"publisher","unstructured":"Mansfield S.A., Kimble A, Rodriguez L, Murphy A.J., Gorantla S, Huang E.Y., Anghelescu D.L., Davidoff A.M. (2020) Validating an opioid prescribing algorithm in post-operative pediatric surgical oncology patients. J Pediatr Surg. https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.09.040","DOI":"10.1016\/j.jpedsurg.2020.09.040"},{"key":"6560_CR22","doi-asserted-by":"publisher","first-page":"e207","DOI":"10.1097\/MPH.0000000000001641","volume":"42","author":"SA Mansfield","year":"2020","unstructured":"Mansfield SA, El Gohary Y, Kimble A, Wynn L, Hall EA, Anghelescu DL, Davidoff AM, Murphy AJ (2020) A quality improvement intervention to decrease postoperative opioid prescriptions in pediatric oncology patients. J Pediatr Hematol Oncol 42:e207\u2013e212. https:\/\/doi.org\/10.1097\/MPH.0000000000001641","journal-title":"J Pediatr Hematol Oncol"},{"key":"6560_CR23","doi-asserted-by":"publisher","unstructured":"Chara AO, Sims JK, Niconchuk J, Zamora IJ (2026) Impact of enhanced recovery after surgery (ERAS) on surgical site infections in pediatric surgery. Semin Pediatr Surg 151581. https:\/\/doi.org\/10.1016\/j.sempedsurg.2026.151581","DOI":"10.1016\/j.sempedsurg.2026.151581"},{"key":"6560_CR24","doi-asserted-by":"publisher","first-page":"162046","DOI":"10.1016\/j.jpedsurg.2024.162046","volume":"60","author":"SA Mansfield","year":"2025","unstructured":"Mansfield SA, Kotagal M, Hartman SJ, Murphy AJ, Davidoff AM, Hogan B, Ha D, Anghelescu DL, Mecoli M, Cost NG, Rove KO (2025) Enhanced recovery after surgery for pediatric abdominal tumor resections: a prospective multi-institution study. J Pediatr Surg 60:162046. https:\/\/doi.org\/10.1016\/j.jpedsurg.2024.162046","journal-title":"J Pediatr Surg"},{"key":"6560_CR25","doi-asserted-by":"publisher","first-page":"10066","DOI":"10.1245\/s10434-025-18403-5","volume":"32","author":"S Srivatsa","year":"2025","unstructured":"Srivatsa S, Aldrink JH, Schneider E, Akbar T, Veneziano G, Ng V, McManaway C, Schwartz D, Jatana K, Mansfield SA (2025) Implementation of an enhanced recovery after surgery pathway for pediatric surgical oncology using quality improvement methodology. Ann Surg Oncol 32:10066\u201310076. https:\/\/doi.org\/10.1245\/s10434-025-18403-5","journal-title":"Ann Surg Oncol"},{"key":"6560_CR26","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/j.suronc.2018.07.013","volume":"27","author":"J Hagendoorn","year":"2018","unstructured":"Hagendoorn J, Nota CLMA, Borel Rinkes IHM, Molenaar IQ (2018) Robotic pancreatoduodenectomy for a solid pseudopapillary tumor in a ten-year-old child. Surg Oncol 27:635\u2013636. https:\/\/doi.org\/10.1016\/j.suronc.2018.07.013","journal-title":"Surg Oncol"},{"key":"6560_CR27","doi-asserted-by":"publisher","first-page":"163044","DOI":"10.1016\/j.jpedsurg.2026.163044","volume":"61","author":"X Chen","year":"2026","unstructured":"Chen X, Zhan Y, Chen Q, Gao Z (2026) Robotic surgery for pancreatic disorders in children: insights from two centers. J Pediatr Surg 61:163044. https:\/\/doi.org\/10.1016\/j.jpedsurg.2026.163044","journal-title":"J Pediatr Surg"},{"key":"6560_CR28","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.surg.2018.03.020","volume":"164","author":"HM Phelps","year":"2018","unstructured":"Phelps HM, Ayers GD, Ndolo JM, Dietrich HL, Watson KD, Hilmes MA, Lovvorn HN (2018) Maintaining oncologic integrity with minimally invasive resection of pediatric embryonal tumors. Surgery 164:333\u2013343. https:\/\/doi.org\/10.1016\/j.surg.2018.03.020","journal-title":"Surgery"},{"key":"6560_CR29","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1016\/j.jss.2024.07.057","volume":"302","author":"MW Wallace","year":"2024","unstructured":"Wallace MW, Ram C, Mina A, Lovvorn HN, Patel A, Hopkins MB, Idrees K, Duke MC, McChesney SL, Khan A, Thomas JC, Jackson GP, Upperman J, Zamora IJ (2024) Collaborative implementation of robotic surgery into an academic pediatric surgery practice. J Surg Res 302:883\u2013890. https:\/\/doi.org\/10.1016\/j.jss.2024.07.057","journal-title":"J Surg Res"},{"key":"6560_CR30","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/j.jpedsurg.2014.04.010","volume":"49","author":"AD Malkan","year":"2014","unstructured":"Malkan AD, Loh AHP, Sandoval JA (2014) Minimally invasive surgery in the management of abdominal tumors in children. J Pediatr Surg 49:1171\u20131176. https:\/\/doi.org\/10.1016\/j.jpedsurg.2014.04.010","journal-title":"J Pediatr Surg"},{"key":"6560_CR31","doi-asserted-by":"publisher","first-page":"804","DOI":"10.3390\/jcm10040804","volume":"10","author":"CM Heske","year":"2021","unstructured":"Heske CM, Mascarenhas L, Rhabdomyosarcoma R (2021) J Clin Med 10:804. https:\/\/doi.org\/10.3390\/jcm10040804","journal-title":"J Clin Med"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06560-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-026-06560-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06560-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:03:13Z","timestamp":1785787393000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-026-06560-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6560"],"URL":"https:\/\/doi.org\/10.1007\/s00383-026-06560-x","relation":{},"ISSN":["1437-9813"],"issn-type":[{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"3 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr. Zamora serves as consultant for Intuitive Surgical and Hologic Surgical.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"325"}}