{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:41:55Z","timestamp":1788302515640,"version":"build-2803163510"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Transenterix","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"Karl Storz Endoskope","award":["-"],"award-info":[{"award-number":["-"]}]},{"DOI":"10.13039\/501100002869","name":"Christian-Albrechts-Universit\u00e4t zu Kiel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002869","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>No data exist concerning the appication of a new robotic system with 3\u00a0mm instruments (Senhance\u00ae, Transenterix) in infants and small children. Therefore, the aim of this study was to test the system for its feasibility, performance and safety of robotic pediatric abdominal and thoracic surgery in piglets simulating infants with a body weight lower than 10\u00a0kg. 34 procedures (from explorative laparoscopy to thoracoscopic esophageal repair) were performed in 12 piglets with a median age of 23 (interquartile range: 12\u201328) days and a median body weight of 6.9 (6.1\u20137.3) kg. The Senhance\u00ae robotic system was used with 3\u00a0mm instruments, a 10\u00a0mm 3D 0\u00b0 or 30\u00b0 videoscope and advanced energy devices, the setup consisted of the master console and three separate arms. The amount, size, and position of the applied ports, their distance as well as the distance between the three operator arms of the robot, external and internal collisions, and complications of the procedures were recorded and analyzed. We were able to perform all planned surgical procedures with 3\u00a0mm robotic instruments in piglets with a median body weight of less than 7\u00a0kg. We encountered two non-robot associated complications (bleeding from the inferior caval and hepatic vein) which led to termination of the live procedures. Technical limitations were the reaction time and speed of robotic camera movement with eye tracking, the excessive bending of the 3\u00a0mm instruments and intermittent need of re-calibration of the fulcrum point. Robotic newborn and infant surgery appears technically feasible with the Senhance\u00ae system. Software adjustments for camera movement and sensitivity of the fulcrum point calibration algorithm to adjust for the increased compliance of the abdominal wall of infants, therefore reducing the bending of the instruments, need to be implemented by the manufacturer as a result of our study. To further evaluate the Senhance\u00ae system, prospective trials comparing it to open, laparoscopic and other robotic systems are needed.<\/jats:p>","DOI":"10.1007\/s11701-021-01229-0","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T21:02:36Z","timestamp":1616792556000},"page":"215-228","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Robotic infant surgery with 3\u00a0mm instruments: a study in piglets of less than 10\u00a0kg body weight"],"prefix":"10.1007","volume":"16","author":[{"given":"Thomas F.","family":"Krebs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Hendrik","family":"Egberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Lorenzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin F.","family":"Krause","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Reischig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberts","family":"Meiksans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Baastrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Meinzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Alkatout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesa","family":"Cohrs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Wieker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"L\u00fcthje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Vieten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Schultheiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-8440","authenticated-orcid":false,"given":"Robert","family":"Bergholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,26]]},"reference":[{"key":"1229_CR1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.yapd.2014.03.011","volume":"61","author":"HT Jackson","year":"2014","unstructured":"Jackson HT, Kane TD (2014) Advances in minimally invasive surgery in pediatric patients. 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He was also funded by Karl Storz (Tuttlingen, Germany) with supply of the Endoflator and Unimat device. Furthermore, he is a stockholder of Transenterix (TRXC) and Titan Medical (TMDI), a competing robotic surgery company. Author Jan-Hendrik Egberts serves as a proctor for Intuitive surgical. The authors, Thomas Krebs, Ulf Lorenzen, Martin F. Krause, Katja Reischig, Roberts Meiksans, Jonas Baastrup, Andreas Meinzer, Ibrahim Alkatout, Gesa Cohrs, Henning Wieker, Annette Luethje, Sarah Vieten, and Gerhard Schultheiss, declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}