{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:12:49Z","timestamp":1773155569067,"version":"3.50.1"},"reference-count":86,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"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":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Robotic-assisted surgery (RAS) emerged as a transformative approach in various surgical disciplines, particularly in adult cardiothoracic procedures, where it has demonstrated significant benefits such as enhanced precision, improved visualisation, and reduced complication rates. Despite its success in adult surgeries, including mitral valve repairs and coronary artery revascularisations, the application of RAS in neonatal cardiothoracic surgery remains largely unexplored. This narrative review synthesises existing evidence, highlighting the potential of RAS to address the unique challenges posed by neonatal cardiothoracic procedures, which require intricate manoeuvrability and precision within confined anatomical spaces. The review also examines the successes of minimally invasive techniques, such as laparoscopic and thoracoscopic surgeries, in paediatric patients, particularly those with congenital heart disease (CHD), demonstrating their safety and efficacy even in high-risk populations. These findings suggest that RAS could offer similar, if not superior, benefits in neonatal cardiothoracic surgeries in future. Significant gaps in the literature, particularly regarding long-term outcomes and the technical challenges of RAS adaptation for neonatal use, underscore the need for further research. Likewise, technological iterations in the currently available systems (including instrument size and curvature, scope definition and haptic feedback) are required to make this concept a reality by meeting the standard of care. This review argues that while RAS holds considerable promise for improving surgical outcomes in neonates, dedicated research is essential to overcome and fully realise its potential. This review not only underscores the current successes of RAS in adult and paediatric surgeries but also sets a foundation for future exploration into its application in neonatal cardiothoracic procedures, advocating for continued innovation and research in this promising field.<\/jats:p>","DOI":"10.1007\/s11701-025-03004-x","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T02:22:36Z","timestamp":1764382956000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the future of robotic approaches in neonatal cardiac surgery: opportunities, barriers, and innovation pathways"],"prefix":"10.1007","volume":"20","author":[{"given":"Siena","family":"Martin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirkomol","family":"Mirzarakhimov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-0377","authenticated-orcid":false,"given":"Omar","family":"Shafi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Camacho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"issue":"2","key":"3004_CR1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1038\/s41573-020-0090-8","volume":"20","author":"MJ Mitchell","year":"2021","unstructured":"Mitchell MJ, Billingsley MM, Haley RM, Wechsler ME, Peppas NA, Langer R (2021) Engineering precision nanoparticles for drug delivery. Nat Rev Drug Discov 20(2):101\u2013124","journal-title":"Nat Rev Drug Discov"},{"issue":"23","key":"3004_CR2","doi-asserted-by":"publisher","DOI":"10.3390\/electronics13234675","volume":"13","author":"P Picozzi","year":"2024","unstructured":"Picozzi P, Nocco U, Labate C, Gambini I, Puleo G, Silvi F et al (2024) Advances in robotic surgery: a review of new surgical platforms. Electronics 13(23):4675","journal-title":"Electronics"},{"key":"3004_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/mame.202500023","author":"O Shafi","year":"2025","unstructured":"Shafi O, Swer M, Chan UH, Kassam A, Mirzarakhimov M, Huang JY et al (2025) Surfactant\u2010modified progesterone\u2010loaded PVP\/cellulose fibres for future drug delivery applications in menopause. Macromol Mater Eng. https:\/\/doi.org\/10.1002\/mame.202500023","journal-title":"Macromol Mater Eng"},{"issue":"4","key":"3004_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/mame.202300447","volume":"309","author":"O Shafi","year":"2024","unstructured":"Shafi O, Phadnis S, Chan UH, Edirisinghe M, Brako F (2024) High dose progesterone loaded PCL-Polysorbate 80 transdermal fibers for potential application in gynecological oncology. Macromol Mater Eng 309(4):1\u201311","journal-title":"Macromol Mater Eng"},{"issue":"3","key":"3004_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/children11030270","volume":"11","author":"ER Iacob","year":"2024","unstructured":"Iacob ER, Iacob R, Ghenciu LA, Popoiu TA, Stoicescu ER, Popoiu CM (2024) Small scale, high precision: robotic surgery in neonatal and pediatric patients\u2014A. narrative rev. Child 11(3):270","journal-title":"Child"},{"issue":"6","key":"3004_CR6","doi-asserted-by":"publisher","first-page":"564","DOI":"10.21037\/acs-2022-rmvs-26","volume":"11","author":"JrWR Chitwood","year":"2022","unstructured":"Chitwood Jr WR (2022) Historical evolution of robot-assisted cardiac surgery: a 25-year journey. Ann Cardiothorac Surg 11(6):564\u201382","journal-title":"Ann Cardiothorac Surg"},{"issue":"5","key":"3004_CR7","doi-asserted-by":"publisher","first-page":"525","DOI":"10.21037\/acs-2022-rmvs-73","volume":"11","author":"A Amabile","year":"2022","unstructured":"Amabile A, Morrison A, LaLonde M, Agarwal R, Mori M, Hameed I et al (2022) Two hundred robotic mitral valve repair procedures for degenerative mitral regurgitation: the Yale experience. Ann Cardiothorac Surg 11(5):525\u2013532","journal-title":"Ann Cardiothorac Surg"},{"issue":"2","key":"3004_CR8","doi-asserted-by":"publisher","first-page":"271","DOI":"10.21037\/tp-22-338","volume":"12","author":"A Boscarelli","year":"2023","unstructured":"Boscarelli A, Giglione E, Caputo MR, Guida E, Iaquinto M, Scarpa MG et al (2023) Robotic-assisted surgery in pediatrics: what is evidence-based?\u2014a literature review. Transl Pediatr 12(2):271\u2013279","journal-title":"Transl Pediatr"},{"issue":"6","key":"3004_CR9","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1016\/j.athoracsur.2020.11.062","volume":"112","author":"JP Jacobs","year":"2021","unstructured":"Jacobs JP, Pruitt EY, Badhwar V (2021) Robotic surgery for pediatric and congenital cardiac disease. Ann Thorac Surg 112(6):2028","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"3004_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/wjps-2022-000482","volume":"5","author":"LT Shen","year":"2022","unstructured":"Shen LT, Tou J (2022) Application and prospects of robotic surgery in children: a scoping review. World J Pediatr Surg 5(4):e000482","journal-title":"World J Pediatr Surg"},{"key":"3004_CR11","unstructured":"Shafi O Engineering for Obstetrics and Gynaecology: Fabrication of the Transdermal Progesterone Patch [Internet]. 2024 [cited 2025 Mar 8]. Available from: https:\/\/scholar.google.com\/citations?view_op=view_citation&hl=en&user=7h810K0AAAAJ&citation_for_view=7h810K0AAAAJ:d1gkVwhDpl0C"},{"key":"3004_CR12","doi-asserted-by":"crossref","unstructured":"Shafi O, Edirisinghe M, Brako F (2022) Polysorbate enhanced progesterone loaded drug diffusion from macromolecular fibrous patches for applications in obstetrics and gynaecology. J Drug Deliv Sci Technol [Internet]. ;104062. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S177322472200973X","DOI":"10.2139\/ssrn.4177751"},{"key":"3004_CR13","doi-asserted-by":"publisher","DOI":"10.1155\/jocs\/4692522","author":"ME Lee","year":"2025","unstructured":"Lee ME, Amabile A, Hameed I, Antonios J, Awad AK, Brackett A et al (2025) Robotic congenital cardiac surgery practice worldwide: a systematic review. J Card Surg. https:\/\/doi.org\/10.1155\/jocs\/4692522","journal-title":"J Card Surg"},{"issue":"6","key":"3004_CR14","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/j.athoracsur.2020.10.028","volume":"112","author":"B Onan","year":"2021","unstructured":"Onan B, Onan IS (2021) Early results of robotically assisted congenital cardiac surgery: analysis of 242 patients. Ann Thorac Surg 112(6):2020\u20132027","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"3004_CR15","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1111\/aor.13357","volume":"43","author":"B Onan","year":"2019","unstructured":"Onan B, Aydin U, Kadirogullari E, Onan IS, Sen O (2019) Totally endoscopic robotic-assisted cardiac surgery in children. Artif Organs 43(4):342\u2013349","journal-title":"Artif Organs"},{"issue":"2","key":"3004_CR16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1093\/ije\/dyz009","volume":"48","author":"Y Liu","year":"2019","unstructured":"Liu Y, Chen S, Z\u00fchlke L, Black GC, Choy Mkit, Li N et al (2019) Global birth prevalence of congenital heart defects 1970\u20132017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol 48(2):455\u201363","journal-title":"Int J Epidemiol"},{"issue":"4","key":"3004_CR17","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s11701-007-0050-x","volume":"1","author":"C Nguan","year":"2008","unstructured":"Nguan C, Girvan A, Luke PP (2008) Robotic surgery versus laparoscopy; a comparison between two robotic systems and laparoscopy. J Robot Surg 1(4):263\u2013268","journal-title":"J Robot Surg"},{"key":"3004_CR18","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.xjtc.2021.12.018","volume":"13","author":"HH Balkhy","year":"2022","unstructured":"Balkhy HH, Nisivaco S, Torregrossa G, Kitahara H, Patel B, Grady K et al (2022) Multi-spectrum robotic cardiac surgery: early outcomes. JTCVS Tech 13:74\u201382","journal-title":"JTCVS Tech"},{"issue":"10","key":"3004_CR19","doi-asserted-by":"publisher","first-page":"6032","DOI":"10.1016\/j.asjsur.2025.03.364","volume":"48","author":"C Delgado-Miguel","year":"2025","unstructured":"Delgado-Miguel C, Camps JI (2025) Robotic surgery in newborns and infants under 12-months: is it feasible? Asian J Surg 48(10):6032\u20136036","journal-title":"Asian J Surg"},{"issue":"10","key":"3004_CR20","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1089\/lap.2016.0232","volume":"26","author":"J Kim","year":"2016","unstructured":"Kim J, Sun Z, Englum BR, Allori AC, Adibe OO, Rice HE et al (2016) Laparoscopy is safe in infants and neonates with congenital heart disease: a national study of 3684 patients. J Laparoendosc Adv Surg Tech 26(10):836\u20139","journal-title":"J Laparoendosc Adv Surg Tech"},{"issue":"1","key":"3004_CR21","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1109\/TMRB.2021.3049878","volume":"3","author":"MM Marinho","year":"2021","unstructured":"Marinho MM, Harada K, Deie K, Ishimaru T, Mitsuishi M (2021) SmartArm: suturing feasibility of a surgical robotic system on a neonatal chest model. IEEE Trans Med Robot Bionics 3(1):253\u20136","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"Supplement 7","key":"3004_CR22","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1308\/rcsann.supp2.22","volume":"100","author":"A Sepehripour","year":"2018","unstructured":"Sepehripour A, Garas G, Athanasiou T, Casula R (2018) Robotics in cardiac surgery. Ann R Coll Surg Engl 100(Supplement 7):22\u201333","journal-title":"Ann R Coll Surg Engl"},{"issue":"9","key":"3004_CR23","volume":"10","author":"G Koulaouzidis","year":"2023","unstructured":"Koulaouzidis G, Charisopoulou D, Bomba P, Stachura J, Gasior P, Harpula J et al (2023) Robotic-assisted solutions for invasive cardiology, cardiac surgery and routine on-ward tasks: a narrative review. J Cardiovasc Dev Dis 10(9):399","journal-title":"J Cardiovasc Dev Dis"},{"issue":"1","key":"3004_CR24","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.jtcvs.2017.07.037","volume":"155","author":"AM Gillinov","year":"2018","unstructured":"Gillinov AM, Mihaljevic T, Javadikasgari H, Suri RM, Mick SL, Navia JL et al (2018) Early results of robotically assisted mitral valve surgery: analysis of the first 1000 cases. J Thorac Cardiovasc Surg 155(1):82-91e2","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"14","key":"3004_CR25","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.jacc.2010.03.085","volume":"56","author":"P Khairy","year":"2010","unstructured":"Khairy P, Ionescu-Ittu R, Mackie AS, Abrahamowicz M, Pilote L, Marelli AJ (2010) Changing mortality in congenital heart disease. J Am Coll Cardiol 56(14):1149\u20131157","journal-title":"J Am Coll Cardiol"},{"issue":"21","key":"3004_CR26","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1016\/j.jacc.2011.08.025","volume":"58","author":"D van der Linde","year":"2011","unstructured":"van der Linde D, Konings EEM, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJM et al (2011) Birth prevalence of congenital heart disease worldwide. J Am Coll Cardiol 58(21):2241\u20132247","journal-title":"J Am Coll Cardiol"},{"key":"3004_CR27","doi-asserted-by":"publisher","first-page":"35","DOI":"10.21037\/pm-21-47","volume":"5","author":"L Kiraly","year":"2022","unstructured":"Kiraly L (2022) Current outcomes and future trends in paediatric and congenital cardiac surgery: a narrative review. Pediatr Med (Kaohsiung) 5:35\u201335","journal-title":"Pediatr Med (Kaohsiung)"},{"key":"3004_CR28","volume-title":"Perioperative management of patients with congenital heart disease","author":"A Tariq","year":"2023","unstructured":"Tariq A, Bora V (2023) In: TreasureIsland (ed) Perioperative management of patients with congenital heart disease. StatPearls, FL"},{"issue":"5","key":"3004_CR29","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1016\/j.athoracsur.2020.06.036","volume":"111","author":"PS Naimo","year":"2021","unstructured":"Naimo PS, Konstantinov IE (2021) Surgery for truncus arteriosus: contemporary practice. Ann Thorac Surg 111(5):1442\u20131450","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"3004_CR30","doi-asserted-by":"publisher","first-page":"122","DOI":"10.4103\/0974-2069.157025","volume":"8","author":"S Marathe","year":"2015","unstructured":"Marathe S, Talwar S (2015) Surgery for transposition of great arteries: a historical perspective. Ann Pediatr Cardiol 8(2):122","journal-title":"Ann Pediatr Cardiol"},{"issue":"8","key":"3004_CR31","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.3390\/children9081264","volume":"9","author":"B Shu","year":"2022","unstructured":"Shu B, Feng X, Martynov I, Lacher M, Mayer S (2022) Pediatric minimally invasive surgery\u2014a bibliometric study on 30 years of research activity. Children 9(8):1264","journal-title":"Children"},{"issue":"1","key":"3004_CR32","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1038\/nrcardio.2013.168","volume":"11","author":"E Bacha","year":"2014","unstructured":"Bacha E, Kalfa D (2014) Minimally invasive paediatric cardiac surgery. Nat Rev Cardiol 11(1):24\u201334","journal-title":"Nat Rev Cardiol"},{"issue":"10","key":"3004_CR33","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1016\/j.jpedsurg.2021.01.028","volume":"56","author":"FKF Lam","year":"2021","unstructured":"Lam FKF, Lau CT, Yu MO, Wong KKY (2021) Comparison of thoracoscopy vs. thoracotomy on musculoskeletal outcomes of children with congenital pulmonary airway malformation (CPAM). J Pediatr Surg 56(10):1732\u20131736","journal-title":"J Pediatr Surg"},{"issue":"1","key":"3004_CR34","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/j.athoracsur.2008.08.069","volume":"87","author":"TA Lawal","year":"2009","unstructured":"Lawal TA, Gosemann JH, Kuebler JF, Gl\u00fcer S, Ure BM (2009) Thoracoscopy versus thoracotomy improves midterm musculoskeletal status and cosmesis in infants and children. Ann Thorac Surg 87(1):224\u2013228","journal-title":"Ann Thorac Surg"},{"issue":"10","key":"3004_CR35","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1089\/lap.2021.0454","volume":"31","author":"SS Rothenberg","year":"2021","unstructured":"Rothenberg SS (2021) Thoracoscopic lobectomy in infants and children. J Laparoendosc Adv Surg Tech A 31(10):1157\u20131161","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"1","key":"3004_CR36","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1038\/s41572-023-00470-1","volume":"9","author":"F Pederiva","year":"2023","unstructured":"Pederiva F, Rothenberg SS, Hall N, Ijsselstijn H, Wong KKY, von der Th\u00fcsen J et al (2023) Congenital lung malformations. Nat Rev Dis Primers 9(1):60","journal-title":"Nat Rev Dis Primers"},{"issue":"12","key":"3004_CR37","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1007\/s00431-017-3032-7","volume":"176","author":"C Leblanc","year":"2017","unstructured":"Leblanc C, Baron M, Desselas E, Phan MH, Rybak A, Thouvenin G et al (2017) Congenital pulmonary airway malformations: state-of-the-art review for pediatrician\u2019s use. Eur J Pediatr 176(12):1559\u20131571","journal-title":"Eur J Pediatr"},{"issue":"7","key":"3004_CR38","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1002\/pd.1966","volume":"28","author":"P Laje","year":"2008","unstructured":"Laje P, Liechty KW (2008) Postnatal management and outcome of prenatally diagnosed lung lesions. Prenat Diagn 28(7):612\u2013618","journal-title":"Prenat Diagn"},{"issue":"3","key":"3004_CR39","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.jpedsurg.2023.10.060","volume":"59","author":"S Rothenberg","year":"2024","unstructured":"Rothenberg S, Shipman K, Lai S, Kay S (2024) Evaluation of thoracoscopic lobectomy in infants for congenital lung lesions: earlier is better! J Pediatr Surg 59(3):368\u2013371","journal-title":"J Pediatr Surg"},{"issue":"6","key":"3004_CR40","doi-asserted-by":"publisher","first-page":"e785","DOI":"10.1542\/peds.2005-0650","volume":"116","author":"N Kalfa","year":"2005","unstructured":"Kalfa N, Allal H, Raux O, Lopez M, Forgues D, Guibal MP et al (2005) Tolerance of laparoscopy and thoracoscopy in neonates. Pediatrics 116(6):e785\u2013e791","journal-title":"Pediatrics"},{"issue":"12","key":"3004_CR41","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1016\/j.jpedsurg.2021.04.013","volume":"56","author":"JH Weller","year":"2021","unstructured":"Weller JH, Peter S DSt, Fallat ME, Saito JM, Burns CR, Deans KJ et al (2021) Thoracoscopic versus open lobectomy in infants with congenital lung malformations: a multi-institutional propensity score analysis. J Pediatr Surg 56(12):2148\u201356","journal-title":"J Pediatr Surg"},{"issue":"4","key":"3004_CR42","doi-asserted-by":"publisher","first-page":"332","DOI":"10.4103\/jiaps.jiaps_80_23","volume":"28","author":"R Menon","year":"2023","unstructured":"Menon R, Rathod K, Rathod D, Kumar P, Yadav T, Sinha A (2023) Thoracoscopic repair of iatrogenic bronchial injury in a neonate during bronchogenic cyst excision. J Indian Assoc Pediatr Surg 28(4):332","journal-title":"J Indian Assoc Pediatr Surg"},{"issue":"6","key":"3004_CR43","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1016\/j.jpedsurg.2012.03.008","volume":"47","author":"LA Gillory","year":"2012","unstructured":"Gillory LA, Megison ML, Harmon CM, Chen MK, Anderson S, Chong AJ et al (2012) Laparoscopic surgery in children with congenital heart disease. J Pediatr Surg 47(6):1084\u20138","journal-title":"J Pediatr Surg"},{"issue":"10","key":"3004_CR44","doi-asserted-by":"publisher","first-page":"1980","DOI":"10.1016\/j.jpedsurg.2017.10.052","volume":"53","author":"DI Chu","year":"2018","unstructured":"Chu DI, Tan JM, Mattei P, Simpao AF, Costarino AT, Shukla AR et al (2018) Outcomes of laparoscopic and open surgery in children with and without congenital heart disease. J Pediatr Surg 53(10):1980\u20138","journal-title":"J Pediatr Surg"},{"issue":"4","key":"3004_CR45","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1089\/lap.2013.0157","volume":"24","author":"C Burgmeier","year":"2014","unstructured":"Burgmeier C, Schier F (2014) Hemodynamic effects of thoracoscopic surgery in neonates with cardiac anomalies. J Laparoendosc Adv Surg Tech 24(4):265\u2013267","journal-title":"J Laparoendosc Adv Surg Tech"},{"key":"3004_CR46","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.jpeds.2017.02.011","volume":"185","author":"DI Chu","year":"2017","unstructured":"Chu DI, Tan JM, Mattei P, Costarino AT, Rossano JW, Tasian GE (2017) Mortality and morbidity after laparoscopic surgery in children with and without congenital heart disease. J Pediatr 185:88-93.e3","journal-title":"J Pediatr"},{"key":"3004_CR47","unstructured":"Gallego-Poveda J, PN, AMJ, GRD, SE, PD RA (2024) Minimally invasive mitral valve repair: from total endoscopic to Closed-Chest robotic. Pediatr J Cardiothorac Surg"},{"issue":"3","key":"3004_CR48","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1109\/TMRB.2024.3422618","volume":"6","author":"Z Chen","year":"2024","unstructured":"Chen Z, Fan K, Cruciani L, Fontana M, Muraglia L, Ceci F et al (2024) Toward human-out-of-the-loop endoscope navigation based on context awareness for enhanced autonomy in robotic surgery. IEEE Trans Med Robot Bionics 6(3):1116\u20131124","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"2","key":"3004_CR49","doi-asserted-by":"publisher","DOI":"10.1136\/wjps-2023-000748","volume":"7","author":"L Liang","year":"2024","unstructured":"Liang L, Tan Z, Huang T, Gao Y, Zhang J, Yu J et al (2024) Efficacy of robot-assisted thoracoscopic surgery in the treatment of pulmonary sequestration in children. World J Pediatr Surg 7(2):e000748","journal-title":"World J Pediatr Surg"},{"issue":"10","key":"3004_CR50","doi-asserted-by":"publisher","first-page":"3854","DOI":"10.21037\/jtd-22-526","volume":"14","author":"S Li","year":"2022","unstructured":"Li S, Luo Z, Li K, Li Y, Yang D, Cao G et al (2022) Robotic approach for pediatric pulmonary resection: preliminary investigation and comparative study with thoracoscopic approach. J Thorac Dis 14(10):3854\u20133864","journal-title":"J Thorac Dis"},{"issue":"9","key":"3004_CR51","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1016\/j.jpedsurg.2020.11.009","volume":"56","author":"M Durand","year":"2021","unstructured":"Durand M, Musleh L, Vatta F, Orofino G, Querciagrossa S, Jugie M et al (2021) Robotic lobectomy in children with severe bronchiectasis: a worthwhile new technology. J Pediatr Surg 56(9):1606\u201310","journal-title":"J Pediatr Surg"},{"key":"3004_CR52","volume-title":"Latest Developments in Medical Robotics Systems","author":"M Navarrete-Arellano","year":"2021","unstructured":"Navarrete-Arellano M (2021) Robotic-Assisted Minimally Invasive Surgery in Children. Latest Developments in Medical Robotics Systems. IntechOpen"},{"issue":"7","key":"3004_CR53","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1016\/j.jpedsurg.2012.01.067","volume":"47","author":"JC Fraga","year":"2012","unstructured":"Fraga JC, Rothenberg S, Kiely E, Pierro A (2012) Video-assisted thoracic surgery resection for pediatric mediastinal neurogenic tumors. J Pediatr Surg 47(7):1349\u20131353","journal-title":"J Pediatr Surg"},{"issue":"11","key":"3004_CR54","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1016\/j.jpedsurg.2020.02.019","volume":"55","author":"JP Gurria","year":"2020","unstructured":"Gurria JP, Malek MM, Heaton TE, Gehred A, Lautz TB, Rhee DS et al (2020) Minimally invasive surgery for abdominal and thoracic neuroblastic tumors: a systematic review by the APSA Cancer committee. J Pediatr Surg 55(11):2260\u201372","journal-title":"J Pediatr Surg"},{"issue":"3","key":"3004_CR55","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1093\/icvts\/ivu406","volume":"20","author":"Q Ballouhey","year":"2015","unstructured":"Ballouhey Q, Villemagne T, Cros J, Vacquerie V, B\u00e9renguer D, Braik K et al (2015) Assessment of paediatric thoracic robotic surgery. Interact Cardiovasc Thorac Surg 20(3):300\u2013303","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"3004_CR56","doi-asserted-by":"publisher","DOI":"10.1016\/j.sempedsurg.2023.151262","volume":"32","author":"WJ Svetanoff","year":"2023","unstructured":"Svetanoff WJ, Bergus KC, Xia J, Diefenbach KA, Michalsky MP, Aldrink JH (2023) Robotic-assisted resection of mediastinal tumors in pediatric patients. Semin Pediatr Surg 32(1):151262","journal-title":"Semin Pediatr Surg"},{"issue":"1","key":"3004_CR57","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1089\/lap.2007.0092","volume":"18","author":"JJ Meehan","year":"2008","unstructured":"Meehan JJ, Sandler AD (2008) Robotic resection of mediastinal masses in children. J Laparoendosc Adv Surg Tech A 18(1):114\u2013119","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"1","key":"3004_CR58","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-022-01487-6","volume":"8","author":"Y Nemoto","year":"2022","unstructured":"Nemoto Y, Kuroda K, Mori M, Kanayama M, Kuwata T, Takenaka M et al (2022) Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with preserving the artery of Adamkiewicz. Surg Case Rep 8(1):129","journal-title":"Surg Case Rep"},{"issue":"10","key":"3004_CR59","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1016\/j.jpedsurg.2007.06.013","volume":"42","author":"JJ Meehan","year":"2007","unstructured":"Meehan JJ, Sandler A (2007) Robotic repair of a Bochdalek congenital diaphragmatic hernia in a small neonate: robotic advantages and limitations. J Pediatr Surg 42(10):1757\u20131760","journal-title":"J Pediatr Surg"},{"issue":"02","key":"3004_CR60","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1055\/s-0040-1721770","volume":"32","author":"PA Ferrero","year":"2022","unstructured":"Ferrero PA, Blanc T, Binet A, Arnaud A, Abbo O, Vatta F et al (2022) The potential and the limitations of esophageal robotic surgery in children. Eur J Pediatr Surg 32(02):170\u2013176","journal-title":"Eur J Pediatr Surg"},{"key":"3004_CR61","doi-asserted-by":"crossref","unstructured":"Li S, Cao G, Zhou R, Zhang X, Zhou Y, Tang S (2021) tao. Feasible techniques in robotic thoracoscopic repair of congenital esophageal atresia: case report and literature review. Surg Case Rep. ;7(1):142","DOI":"10.1186\/s40792-021-01229-0"},{"key":"3004_CR62","doi-asserted-by":"publisher","first-page":"9","DOI":"10.21037\/pm.2019.03.06","volume":"2","author":"L Bertolaccini","year":"2019","unstructured":"Bertolaccini L, Pardolesi A (2019) Approaches to the thoracic cavities. Pediatr Med 2:9\u20139","journal-title":"Pediatr Med"},{"key":"3004_CR63","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/978-3-030-21870-6_15","volume-title":"Critical care of children with heart disease","author":"W Koh","year":"2020","unstructured":"Koh W, Morell E, Viegas M, Moguillansky D, Kazmerski TM, Munoz RA (2020) Ventricular septal defects. Critical care of children with heart disease. Springer International Publishing, Cham, pp 165\u2013171. https:\/\/doi.org\/10.1007\/978-3-030-21870-6_15"},{"key":"3004_CR64","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.xjtc.2024.01.015","volume":"24","author":"A Adilbekova","year":"2024","unstructured":"Adilbekova A, Marassulov S, Baigenzhin A, Kozhakhmetov S, Nurkeyev B, Kerimkulov A et al (2024) Hybrid versus traditional method closure of ventricular septal defects in children. JTCVS Tech 24:137\u201344","journal-title":"JTCVS Tech"},{"issue":"1","key":"3004_CR65","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1186\/s13019-022-01985-6","volume":"17","author":"AR Abdelrehim","year":"2022","unstructured":"Abdelrehim AR, Al-Muhaya M, Alkodami AA, Baangood LS, Al-Mutairi M, Quadeer A et al (2022) Predictors of major adverse events and complications after ventricular septal defects surgical closure in children less than 10 kg. J Cardiothorac Surg 17(1):232","journal-title":"J Cardiothorac Surg"},{"key":"3004_CR66","doi-asserted-by":"crossref","unstructured":"Mirzaaghayan MR, Aghaei Moghadam E, Dehestani A, Ghamari A (2018) Early Surgical Closure of the Ventricular Septal Defects; to Be Done or Not to Be Done? A Question to Be Answered. Iran J Pediatr (In Press(In Press))","DOI":"10.5812\/ijp.58876"},{"issue":"1","key":"3004_CR67","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s00246-021-02685-z","volume":"43","author":"C Minotti","year":"2022","unstructured":"Minotti C, Scioni M, Castaldi B, Guariento A, Biffanti R, Di Salvo G et al (2022) Effectiveness of repair of aortic coarctation in neonates: a long-term experience. Pediatr Cardiol 43(1):17\u201326","journal-title":"Pediatr Cardiol"},{"key":"3004_CR68","unstructured":"Law M (2023) Tivakaran. Vijai. Coarctation of the aorta. StatPearls, editor."},{"issue":"3","key":"3004_CR69","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.jtcvs.2009.04.046","volume":"138","author":"PT Burch","year":"2009","unstructured":"Burch PT, Cowley CG, Holubkov R, Null D, Lambert LM, Kouretas PC et al (2009) Coarctation repair in neonates and young infants: is small size or low weight still a risk factor? J Thorac Cardiovasc Surg 138(3):547\u201352","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"3","key":"3004_CR70","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s42804-023-00210-y","volume":"6","author":"S Aithal","year":"2024","unstructured":"Aithal S, Sinha A, Pathak M (2024) Robotic assisted thoracoscopic surgery in children: a narrated review. J Pediatr Endoscopic Surg 6(3):107\u2013114","journal-title":"J Pediatr Endoscopic Surg"},{"key":"3004_CR71","doi-asserted-by":"crossref","unstructured":"Meehan JJ (2011) Robotic general surgery in neonates and small children. Pediatric robotic and reconstructive urology. Wiley, pp 199\u2013215","DOI":"10.1002\/9781444345292.ch29"},{"issue":"3","key":"3004_CR72","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3109\/13645706.2014.975135","volume":"24","author":"G Pelizzo","year":"2015","unstructured":"Pelizzo G, Nakib G, Romano P, Avolio L, Mencherini S, Zambaiti E et al (2015) Five millimetre-instruments in paediatric robotic surgery: advantages and shortcomings. Minimally Invasive Therapy & Allied Technologies 24(3):148\u2013153","journal-title":"Minimally Invasive Therapy & Allied Technologies"},{"issue":"6","key":"3004_CR73","doi-asserted-by":"publisher","DOI":"10.3390\/children9060805","volume":"9","author":"EM Brownlee","year":"2022","unstructured":"Brownlee EM, Slack M (2022) The role of the versius surgical robotic system in the paediatric population. Children 9(6):805","journal-title":"Children"},{"key":"3004_CR74","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.xjon.2023.10.029","volume":"16","author":"GV Atroshchenko","year":"2023","unstructured":"Atroshchenko GV, Navarra E, Valdis M, Sandoval E, Hashemi N, Cerny S et al (2023) Simulation-based assessment of robotic cardiac surgery skills: an international multicenter, cross-specialty trial. JTCVS Open 16:619\u2013627","journal-title":"JTCVS Open"},{"key":"3004_CR75","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2024.1402596","author":"EL Davidson","year":"2024","unstructured":"Davidson EL, Penniston KL, Farhat WA (2024) Advancements in surgical education: exploring animal and simulation models in fetal and neonatal surgery training. Front Pediatr. https:\/\/doi.org\/10.3389\/fped.2024.1402596","journal-title":"Front Pediatr"},{"issue":"1","key":"3004_CR76","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s11701-021-01229-0","volume":"16","author":"TF Krebs","year":"2022","unstructured":"Krebs TF, Egberts JH, Lorenzen U, Krause MF, Reischig K, Meiksans R et al (2022) Robotic infant surgery with 3\u00a0mm instruments: a study in piglets of less than 10 kg body weight. J Robot Surg 16(1):215\u2013228","journal-title":"J Robot Surg"},{"key":"3004_CR77","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2015.00010","volume":"3","author":"NE Bruns","year":"2015","unstructured":"Bruns NE, Soldes OS, Ponsky TA (2015) Robotic surgery may not \u201cmake the cut\u201d in pediatrics. Front Pediatr 3:10","journal-title":"Front Pediatr"},{"issue":"3","key":"3004_CR78","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1177\/0300060513481922","volume":"41","author":"LW Li","year":"2013","unstructured":"Li LW, Zhang W, Ai YQ, Li L, Peng ZQ, Wang HW (2013) Influence of laparoscopic carbon dioxide pneumoperitoneum on neonate circulation and respiration. J Int Med Res 41(3):889\u2013894","journal-title":"J Int Med Res"},{"issue":"3","key":"3004_CR79","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.athoracsur.2018.12.016","volume":"107","author":"JP Jacobs","year":"2019","unstructured":"Jacobs JP, Mayer JE, Pasquali SK, Hill KD, Overman DM, St. Louis JD et al (2019) The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2019 update on outcomes and quality. Ann Thorac Surg 107(3):691\u2013704","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"3004_CR80","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1016\/j.athoracsur.2021.10.002","volume":"112","author":"SR Kumar","year":"2021","unstructured":"Kumar SR, Mayer JE, Overman DM, Shashidharan S, Wellnitz C, Jacobs JP (2021) The society of thoracic surgeons congenital heart surgery database: 2021 update on outcomes and research. Ann Thorac Surg 112(6):1753\u20131762","journal-title":"Ann Thorac Surg"},{"key":"3004_CR81","unstructured":"FUTEK (2023) Taking robotic surgery to the next level with haptic feedback sensors. Surg Rob Technol. https:\/\/www.surgicalroboticstechnology.com\/articles\/taking-robotic-surgery-to-the-next-level-with-haptic-feedback-sensors\/"},{"issue":"1","key":"3004_CR82","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/SLA.0000000000002693","volume":"268","author":"DA Hashimoto","year":"2018","unstructured":"Hashimoto DA, Rosman G, Rus D, Meireles OR (2018) Artificial intelligence in surgery: promises and perils. Ann Surg 268(1):70\u201376","journal-title":"Ann Surg"},{"issue":"1","key":"3004_CR83","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11701-023-01801-w","volume":"18","author":"S Chatterjee","year":"2024","unstructured":"Chatterjee S, Das S, Ganguly K, Mandal D (2024) Advancements in robotic surgery: innovations, challenges and future prospects. J Robot Surg 18(1):28","journal-title":"J Robot Surg"},{"issue":"1","key":"3004_CR84","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/TMRB.2019.2957061","volume":"2","author":"L Qian","year":"2020","unstructured":"Qian L, Wu JY, DiMaio SP, Navab N, Kazanzides P (2020) A review of augmented reality in robotic-assisted surgery. IEEE Trans Med Robot Bionics 2(1):1\u201316","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"5","key":"3004_CR85","doi-asserted-by":"publisher","first-page":"e932","DOI":"10.1097\/SLA.0000000000005808","volume":"278","author":"N Vinit","year":"2023","unstructured":"Vinit N, Vatta F, Broch A, Hidalgo M, Kohaut J, Querciagrossa S et al (2023) Adverse events and morbidity in a multidisciplinary pediatric robotic surgery program. A prospective, observational study. Ann Surg 278(5):e932\u2013e938","journal-title":"Ann Surg"},{"issue":"6","key":"3004_CR86","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1007\/s11701-022-01377-x","volume":"16","author":"B Shanahan","year":"2022","unstructured":"Shanahan B, Kreaden US, Sorensen J, Stamenkovic S, Redmond KC (2022) Is robotic lobectomy cheaper? A micro-cost analysis. J Robot Surg 16(6):1441\u20131450","journal-title":"J Robot Surg"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-025-03004-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-025-03004-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-025-03004-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T05:16:40Z","timestamp":1764393400000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-025-03004-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,29]]},"references-count":86,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3004"],"URL":"https:\/\/doi.org\/10.1007\/s11701-025-03004-x","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,29]]},"assertion":[{"value":"20 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"45"}}