Pediatric robotic surgical assistant (ROSA)

What are the benefits of using the pediatric robotic surgical assistant (ROSA)?

The renowned neurosurgeons practicing at Children's Health have deep experience using ROSA for a variety of procedures, including epilepsy surgery (SEEG), lesion biopsies, electrode placement for deep brain stimulation and placement of laser fibers.

ROSA’s benefits include:

• Smaller incisions -  Surgeons can guide ROSA through small cuts (or incisions), instead of using traditional open surgery techniques that involve removing large portions of the skull.
• Advanced precision - ROSA-assisted surgeries enable surgeons to make cuts with pinpoint precision. This reduces the risk of affecting tissue around the area that surgeons operate on.
• Reduced anesthesia time - ROSA-assisted surgeries are faster than traditional open surgeries. This means your child spends less time under anesthesia.
• Faster recovery - A less invasive surgery means your child can recover faster and go home sooner.
• Reduced side effects - Because the incisions are smaller, your child usually feels less pain and has less risk of infection versus traditional open surgery.

What are the side effects of using the pediatric robotic surgical assistant (ROSA)?

Any surgery comes with side effects, including discomfort and pain. With ROSA, the side effects are less common and usually less severe than with open surgery. This is because ROSA-assisted surgeries are more precise and less invasive.  

What are the risks of using the pediatric robotic surgical assistant (ROSA)?

There are always risks with surgery. These risks include infection and damage to tissue around the area that is being operated on. At Children’s Health, we perform more pediatric neurosurgeries than almost any other center. This gives us the experience and expertise to keep surgery risks to an absolute minimum. Using ROSA helps make these risks even smaller, by making surgeries faster and more precise. 

What to expect with a pediatric robotic surgical assistant (ROSA) procedure

Children’s Health offers comprehensive support for children and families before, during and after neurosurgical procedures. Your neurosurgeon will likely plan the surgery weeks before your child’s ROSA procedure.

What to expect before a pediatric robotic surgical assistant (ROSA) procedure

Before the procedure, your child’s doctors will use imaging tests, including MRI and CT scans, to understand your child’s condition and develop a detailed surgery plan.

A high-resolution MRI that uses an intravenous dye helps your neurosurgeon to see the exact spot to aim for, and the safest path to get there. Your doctors will talk with you about the paths they’ll take. They’ll also answer any of your questions at the initial visit to discuss your child's surgery.

During the pre-operative appointment, our team will also explain how to prepare your child for their procedure, including instructions on when your child needs to stop eating and drinking. Laboratory tests will also be done to make sure your child is healthy and ready for surgery.

What to expect during a pediatric robotic surgical assistant (ROSA) procedure

When it’s time for your child’s procedure, one of our pediatric anesthesiologists will give your child a medicine to make them fall asleep. If many paths will be used (such as with SEEG), your child’s head will be shaved when they are asleep. If only a few paths are planned, their head will be shaved only in those areas.

A neurosurgeon will then use ROSA’s robotic arm to perform the surgery. The surgery team will also use take images that help them guide and evaluate their work. Finally, most children will have a CT scan at the end of the procedure to ensure there isn’t any unexpected bleeding and all implants are in the correct position. Your child will not be awake until we are satisfied with the results. They also will not feel any pain or discomfort during the procedure.

The likelihood of your child experiencing a seizure during these procedures is very unlikely due to the anesthesia medicines given while they are asleep.

What to expect after a pediatric robotic surgical assistant (ROSA) procedure

After the procedure, your child will wake up and be closely monitored by our expert team. We will give your child medication to manage any pain, and will watch for other potential side effects. A local anesthetic medicine will be put around each small surgical cut to reduce any pain. The amount of time your child spends in the hospital can vary depending on their procedure. Some children go home within a day or two. SEEG patients will stay longer, so the team can monitor their seizures before they go home.

How do I prepare my child for a pediatric robotic surgical assistant (ROSA) procedure?

Our neurosurgery team will give you detailed instructions on how to prepare your child. Our child life team is also available to give you advice on how to talk to your child about their procedure, so they can feel as confident and comfortable as possible.

Your neurosurgeons will talk about shaving your child’s hair. They’ll also give them options for shaving their head before surgery or doing something fun like dyeing their hair a different color, shaving it in a crazy way, shaving it off with designs in the remaining hair, etc.

For a young child or teen, the thought of having their head shaved can be stressful. It’s important for them to understand that it will grow back, and that this can be an opportunity to have some fun.

What is my child allowed to eat and drink before a pediatric ROSA (robotic surgical assistant) procedure?

Your child will not be allowed to eat or drink before the procedure. Your care team will give you specific instructions on how long they should avoid food and/or water.

What questions should I ask my provider about a pediatric ROSA (robotic surgical assistant) procedure?

At Children’s Health, we believe you are a critical member of your child’s care team. We are always happy to answer questions.

Some questions you may want to ask our care team may include:

• How many ROSA procedures have you performed?
• Will my child need to spend the night at the hospital after the ROSA procedure?
• Are there other treatment options we should consider?
• What medications should my child stop taking before the ROSA procedure?
• What are the risks and how do you manage them?
• How soon will I be able to see my child after the ROSA procedure?
• Will my child go home with any special equipment after the ROSA procedure?