Letter to the Editor: Robot-Assisted and Minimally Invasive Pediatric Surgery and Urology During the COVID-19 Pandemic: A Short Literature Review.

The COVID-19 outbreak has dramatically impacted our activities of pediatric surgeons and urologists over the past 3 months, especially in the field of minimally invasive surgery (MIS) and robotics. Analyzing the available literature, there is very scarce evidence regarding the use of MIS and robotics for treatment of pediatric surgical and urological pathologies during this pandemic. However, we found some useful information that we would like to share with other pediatric surgeons and urologists through this journal. Based upon the available data, we believe that surgery should only be performed in pediatric patients with emergent/urgent and oncological indications until resolution of the COVID-19 outbreak. Robotics and MIS may be safely performed in such selected children by adopting specific technical precautions such as prevention of aerosol dispersion using filters/suction or adapted systems and appropriate use of electrocautery and other sealing devices for reduction of surgical smoke, as reported in our recent experience. Another key point to manage this pandemic emergency is that all hospitals should provide health care professionals with adequate individual protections and perform universal screening in all patients undergoing surgery. Considering that this pandemic is a rapidly evolving situation with new information available daily, these data resulting from the analysis of literature focused on pediatric robotics and MIS may be further revised and updated.