BACKGROUND Pediatric robotic-assisted surgeries have increased in recent years; however, guidance documents are still lacking. This study aimed to develop evidence-based recommendations, or best practice statements when evidence is lacking or inadequate, to assist surgical teams internationally. METHODS A joint consensus taskforce of anesthesiologists and surgeons from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP) have identified critical areas and reviewed the available evidence. The taskforce comprised 21 experts representing the fields of anesthesia (n = 11) and surgery (n = 10) from clinical centers performing pediatric robotic surgery in the Italian cities of Ancona, Bologna, Milan, Naples, Padua, Pavia, Perugia, Rome, Siena, and Verona. Between December 2020 and September 2021, three meetings, two Delphi rounds, and a final consensus conference took place. RESULTS During the first planning meeting, the panel agreed on the specific objectives, the definitions to apply, and precise methodology. The project was structured into three subtopics: (i) preoperative patient assessment and preparation; (ii) intraoperative management (surgical and anesthesiologic); and (iii) postoperative procedures. Within these phases, the panel agreed to address a total of 18 relevant areas, which spanned preoperative patient assessment and patient selection, anesthesiology, critical care medicine, respiratory care, prevention of postoperative nausea and vomiting, and pain management. CONCLUSION Collaboration among surgeons and anesthesiologists will be increasingly important for achieving safe and effective RAS procedures. These recommendations will provide a review for those who already have relevant experience and should be particularly useful for those starting a new program.

中文翻译：

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小儿机器人手术：意大利小儿和新生儿麻醉与重症监护学会 (SARNePI) 和意大利小儿外科学会 (SICP) 管理专家共识中的问题。

背景技术近年来，小儿机器人辅助手术有所增加；然而，仍然缺乏指导文件。这项研究旨在制定基于证据的建议，或在证据缺乏或不充分时提出最佳实践声明，以协助国际手术团队。方法 来自意大利儿科和新生儿麻醉与重症监护学会 (SARNePI) 和意大利小儿外科学会 (SICP) 的麻醉师和外科医生组成的联合共识工作组确定了关键领域并审查了现有证据。该工作组由来自意大利安科纳、博洛尼亚、米兰、那不勒斯、帕多瓦、帕维亚、佩鲁贾、罗马等城市进行儿科机器人手术的临床中心的 21 名代表麻醉 (n = 11) 和外科 (n = 10) 领域的专家组成。锡耶纳和维罗纳。2020 年 12 月至 2021 年 9 月期间，举行了三次会议、两轮德尔菲会议和一次最终共识会议。结果 在第一次规划会议期间，小组就具体目标、适用的定义和精确的方法达成了一致。该项目分为三个子主题：(i) 术前患者评估和准备；(ii) 术中管理（手术和麻醉）；(iii) 术后程序。在这些阶段中，专家组同意解决总共 18 个相关领域，包括术前患者评估和患者选择、麻醉学、重症监护医学、呼吸护理、预防术后恶心和呕吐以及疼痛管理。结论 外科医生和麻醉师之间的合作对于实现安全有效的 RAS 手术将变得越来越重要。这些建议将为那些已经拥有相关经验的人提供回顾，并且对于那些开始新计划的人特别有用。