TECHNOLOGICAL ADVANCES AND CONTEMPORARY CHALLENGES IN PEDIATRIC LAPAROSCOPIC AND ROBOTIC SURGERY: A NARRATIVE REVIEW

Abstract

Pediatric minimally invasive surgery has undergone significant transformations over recent decades, driven by the consolidation of laparoscopy and the progressive incorporation of robotic surgery across different surgical specialties. These technologies have enabled reduced surgical trauma, decreased postoperative pain, improved anatomical visualization, enhanced technical precision, and faster postoperative recovery. The present study aimed to analyze technological advances, novel techniques, and contemporary instruments applied to pediatric laparoscopic and robotic surgery, as well as to discuss their main clinical, economic, and educational challenges. This study consists of a Narrative Literature Review conducted through searches in databases including PubMed, Scopus, Web of Science, SciELO, and ScienceDirect, covering publications from 2016 to 2026. The research question was developed according to the PICo strategy, considering children undergoing pediatric surgical procedures, technological advances in laparoscopy and robotics, and the contemporary hospital setting. The findings demonstrate that laparoscopy remains established as a safe and effective approach for multiple pediatric indications, while robotic surgery expands the possibilities for complex reconstructive procedures, particularly in pediatric urology. Nevertheless, limitations related to high costs, learning curves, the need for miniaturized instruments, and unequal access persist. It is concluded that pediatric laparoscopic and robotic surgery represents an expanding field with the potential to improve surgical care, provided that it is accompanied by specialized training, critical cost-effectiveness assessment, and the development of technologies adapted to the anatomical specificities of pediatric patients.