A team led by John Meehan, M.D., pediatric surgeon at University of Iowa Children's Hospital and assistant professor of surgery in the Roy J. and Lucille A. Carver College of Medicine, repaired the duodenal atresia defect in Amber Brisby of Montrose, Iowa, on Oct. 14. The procedure connected the child's stomach to her small bowel. In addition to being the youngest patient to ever receive robotic surgery, Amber was also the second smallest at 2.4 kilograms, or about 5.3 pounds.

"Amber is doing very well. She is eating like a champion and growing quite normally," Meehan said.

Meehan performed the procedure using several tiny incisions that ranged in length from only one-fifth of an inch long to one-eighth of an inch. Amber is now the youngest patient to undergo any robotic surgical procedure in the world.

Specialists say their ability to conduct the procedure was largely due to the availability of a five-millimeter camera system funded by Children's Miracle Network and a five-millimeter, 30-degree camera donated by Intuitive Surgical.

"I want to thank Children's Miracle Network and Intuitive Surgical for their efforts in helping us provide the benefits of minimally invasive surgery to small infants and children," Meehan said.

The da Vinci robot is a complex surgical system that allows a surgeon to perform minimally invasive surgery. After establishing access into the body cavity, the physician sits at a computer console that offers a three-dimensional view of the area to be treated with magnification up to 12 times that of normal vision. The surgeon uses special hand controls to manipulate long, narrow, specially hinged surgical instruments that are inserted through the small incisions in the patient.

The complex instruments can be used in hard-to-reach areas and turned in ways that would be impossible with normal wrist dexterity. Altogether, these advantages allow the surgeon to work on a smaller scale and more precisely than standard laparoscopic surgery and even traditional open surgery.

The minimally invasive approach permitted with the robotic surgical system causes less patient discomfort, enables patients to leave the hospital sooner and allows them to recover more quickly than traditional surgical techniques. Meehan and his team have performed approximately 100 robotic procedures in children to date.

The technology currently is approved for use in surgeries in the abdomen, pelvis and chest. Meehan's surgical team was also the first to use a robotic surgical system to repair a diaphragmatic hernia in a neonate.

At the time, that patient, Amber Vairo, was only six days old. She remains the smallest patient to undergo robotic surgery at 2.3 kilograms. In addition, UI Hospitals and Clinics was the first medical center in Iowa to use the da Vinci system to repair a mitral valve in the heart and to perform urological procedures such as radical prostatectomy for removing a cancerous prostate and pyeloplasty for obstructed kidneys.

University of Iowa Children's Hospital is the state's longest-serving children's hospital. More than 130,000 children receive care at University of Iowa Children's Hospital and its network of clinics across the state each year.

Children's Miracle Network is an international nonprofit organization dedicated to helping children by raising funds and awareness for 170 children's hospitals throughout North America. Each year, this network of premier facilities treats more than 14 million children suffering with all types of afflictions.

Children's Miracle Network partners with 135 radio stations and 200 television stations to help support critically ill and injured children. Since it inception in 1983, Children's Miracle Network has raised more than $2 billion for children's hospitals across the country.

For more information:

University of Iowa Children's Hospital

Children's Miracle Network

Intuitive Surgical

da Vinci Surgical System

da Vinci System in Urologic Procedures