Establishing a pediatric robotic surgery program

Robot-assisted minimally invasive surgery has been widely adopted by adult urology practices in the United States and increasingly across the world. Over the past decade, multiple publications have demonstrated the feasibility and safety of robotic urologic surgery in children. Pediatric urologists, who have been slower than their adult counterparts to adopt robot-assisted technology, are now performing robotic surgery with increasing volume and case complexity as patient and surgeon demand increases. Children's hospitals face unique barriers to establishing a robotic surgery program. In this chapter, we summarize the extant literature guiding effective implementation of a robotic surgery program and associated best practices. Establishing a robotic surgery program requires a comprehensive plan that starts with well-defined mission. Cost is a large barrier to acquisition of a robot, and a detailed market and cost analysis is crucial to hospital buy-in. A lead surgeon will need to define initial case selection and plans for expansion of volume and case complexity. A dedicated robotics team with consistent operating room staff is necessary for efficiency. Finally, there should be provisions for data collection, data review, and continuing education.