# Is There a Place for Versius (CMR) Robotic Platform in Children?

## TL;DR

The Versius robotic system was safely used in children as young as six years old, showing promising results for pediatric robotic surgery.

## Contribution

The study demonstrates the feasibility of the Versius robotic platform in pediatric surgery, particularly in younger and smaller patients.

## Key findings

- The Versius system was successfully used in children as young as six years and weighing as little as 15 kg.
- There were no conversions to laparoscopy or open surgery, and postoperative complications were comparable to established robotic systems.
- The system offers modularity and 5 mm instrument compatibility, but challenges like setup time and cable management remain.

## Abstract

What are the main findings?
The Versius robotic system was safely and successfully applied in pediatric patients as young as six years of age and with body weight as low as 15 kg, with no conversions to laparoscopy or open surgery.Early clinical outcomes demonstrated acceptable operative times, short hospital stay, effective postoperative pain control, and a complication profile comparable to early experiences with established robotic platforms.

The Versius robotic system was safely and successfully applied in pediatric patients as young as six years of age and with body weight as low as 15 kg, with no conversions to laparoscopy or open surgery.

Early clinical outcomes demonstrated acceptable operative times, short hospital stay, effective postoperative pain control, and a complication profile comparable to early experiences with established robotic platforms.

What are the implications of the main findings?
The Versius system represents a feasible and promising alternative robotic platform for selected pediatric urological and general surgical procedures.With further technical refinements and growing surgical experience, Versius may expand access to minimally invasive robotic surgery in pediatric populations, particularly in smaller children where current systems have limitations.

The Versius system represents a feasible and promising alternative robotic platform for selected pediatric urological and general surgical procedures.

With further technical refinements and growing surgical experience, Versius may expand access to minimally invasive robotic surgery in pediatric populations, particularly in smaller children where current systems have limitations.

Introduction: Since its introduction in 1994, robot-assisted surgery has advanced significantly and has become a widely accepted tool in minimally invasive surgery. Over the past two decades, robotic technology has also been increasingly adopted in pediatric surgery. Currently, only two robotic systems are officially approved for pediatric use: the da Vinci surgical system and the Senhance system, both of which have certain limitations. To address these challenges, new robotic platforms such as the Versius system are being developed. Materials and Methods: Following approval from the institutional bioethics committee, a total of 14 pediatric patients underwent robotic-assisted surgery using the Versius robotic system between 10 June and 21 October 2024. Procedures included pyeloplasty, vascular hitch, and cholecystectomy. Results: Procedures with the Versius system were performed including children as young as six years of age and with body weight as low as 15 kg. All procedures were completed successfully without conversion to conventional laparoscopy or open surgery. No intraoperative complications were recorded. The overall postoperative complication rate was 21.4% (3/14 cases), including one anastomotic leak, one case of postoperative hematuria, and one case of postoperative ascites. Discussion: The Versius system represents a promising robotic platform for pediatric surgery, offering a different approach to robotic surgery through modularity, mobility, and compatibility with 5 mm instruments. However, several challenges remain, including prolonged setup and docking times, cable management issues, arm conflicts, and limited access to advanced instrumentation. Nevertheless, with ongoing technological development, robotic surgery is likely to play an increasingly important role in pediatric surgical care.