Pediatric Robotic Surgery and Where ABB Fits

Pediatric robotic surgery means operating on children with robot-held instruments, and the patient can be very small. Ports, arms and camera angles that suit a grown man can crowd the belly of a toddler. This post looks at how surgeons first adapted their tools for children, how the da Vinci system made its way into children's hospitals, and the MRI-guided robot that took a bone biopsy from a child this year. ABB does not build surgical robots, so the post also explains where its arms fit and where they cannot go.

A da Vinci surgical system set up over a training dummy at Addenbrooke's Treatment Centre, Cambridge, 2015. Photo: Cmglee / Wikimedia Commons (CC BY-SA 3.0)

How surgeons scaled their tools down for children

For a long time children were operated on as small adults, with instruments made for adults. Boston changed that in the 1930s and 1940s. In 1938 Robert Gross performed the first surgical correction of a patent ductus arteriosus, one of the most common heart defects in children. In 1941 he and William Ladd published Abdominal Surgery of Infancy and Childhood, a book that helped make children's surgery a specialty of its own. Over time surgeons got smaller clamps, needles and retractors, and anaesthesia dosed for a child's weight.

The entrance of Children's Hospital on Longwood Avenue in Boston, around 1912 to 1930. Photo: Boston Public Library via Wikimedia Commons (Free Art License)

Keyhole surgery came next. In 1971 and 1973 Stephen Gans and George Berci published papers in the Journal of Pediatric Surgery on endoscopy and peritoneoscopy in infants and children, looking inside the body through narrow scopes instead of opening it. Over the following decades laparoscopy spread to children's operations such as appendix removal and reflux surgery. Every step needed thinner instruments and cameras that could work in a tighter space, since a child's abdomen leaves the surgeon far less room to move.

Smile Train volunteers give anesthesia to a small boy before his cleft palate surgery at Camp Dhi Qar, Iraq. Photo: Staff Sgt. Brendan Stephens / U.S. Army via Wikimedia Commons (public domain)

Robots reached adult operating rooms around 2000, when the FDA cleared the da Vinci system for general laparoscopic procedures. Children's surgeons tried it soon after. In 2005 a team led by Raju Thomas at Tulane reported robot assisted pyeloplasty in children, the repair of a blocked junction between kidney and ureter. Pyeloplasty is still the most common robotic procedure in children. In February 2008 Mohan Gundeti at the University of Chicago Comer Children's Hospital performed the first robotic reconstruction of a neurogenic bladder in a child.

A da Vinci robot with its arms draped for surgery in an operating room at Hospital HM in Spain, 2015. Photo: Hospitalhoms / Wikimedia Commons (CC BY-SA 4.0)

Pediatric robotic surgery in 2026

Some of the newest work in children uses MRI to guide the robot. On 9 October 2026 Children's National Hospital in Washington described an MRI safe robot and drill, built with Johns Hopkins University, for bone biopsies in children. MRI avoids the ionizing radiation of CT, but anything near the scanner must leave its magnetic field alone, so the robot has no conventional electric motors or metal parts. It moves by air pressure and reads its position with optical sensors. Clinicians place it over the target, and it locks a needle guide on the planned path.

A Philips MRI scanner at Sahlgrenska University Hospital in Gothenburg, the kind of machine the Children's National biopsy robot works with. Photo: Jan Ainali / Wikimedia Commons (CC BY 3.0)

In the first case the team biopsied a lesion in the right femur of an 8 year old. With the patient moved out of the scanner, clinicians used the pneumatic drill and a standard biopsy kit to take three core samples, and a follow up MRI confirmed the path. The procedure took under two hours with no complications and led to a diagnosis of juvenile Paget's disease. A second patient has since been treated with good results, and the pilot clinical trial continues. Teams under Kevin Cleary, Karun Sharma and Dan Stoianovici led the work, which the NIH partly funded.

The pediatric emergency room at Iashvili Children's Hospital in Tbilisi, Georgia, 2015. Photo: AIHA, USAID via Wikimedia Commons (public domain)

A child's size still decides who can have robotic surgery. On 1 October Cedars-Sinai described how 12 year old Angela Beltran had a rare lung tumour removed with robot assisted surgery after a robotic bronchoscopy biopsy. The 3 cm tumour sat by a branch of the windpipe in her left lung. She was just above the weight threshold for the procedure, and surgeons removed the tumour with the lower lobe of that lung. She went home two days later and, two years on, remains cancer free. ABB does not make surgical robots and had no part in these cases. Its arms work in the labs behind them. An ABB YuMi handles samples inside Copan's microbiology systems, for example.

An ABB YuMi holds a pipette next to a lab technician, from ABB's material on robots for labs and hospitals. Photo: ABB

Where pediatric robotic surgery goes next

Hardware is getting smaller. Thinner instruments, single port systems and single task robots like the MRI biopsy device suit children better than large carts with several arms. Robots that work inside scanners also have to do without the motors and steel of an ordinary industrial arm, so an ABB robot will not appear inside an MRI bore. ABB could help with making and testing the small instruments themselves. That is a possibility, and no such project has been announced.

A visitor sits at the surgeon console of a da Vinci system at Addenbrooke's during the 2015 Cambridge Science Festival. Photo: Cmglee / Wikimedia Commons (CC BY-SA 3.0)

Other industries already use a YuMi, a single arm YuMi IRB 14050 or a GoFa CRB 15000 cobot for precise, repetitive assembly of tiny parts, and the same kind of cell could build single use surgical parts. Engineers usually plan and test a cell like that in RobotStudio before it reaches a clean room. In hospital labs, ABB has shown a mobile YuMi concept at its Texas Medical Center research hub in Houston and supplies GoFa cobots for automated lab workstations built with XtalPi in China.

An ABB GoFa CRB 15000 cobot at an automated lab workstation built by ABB and XtalPi in China. Photo: ABB

Cost and volume are the hard part. A children's hospital does fewer operations of each kind than a large adult centre, which makes an expensive robot harder to justify and gives surgeons fewer chances to practise. Cedars-Sinai handled this by bringing an adult thoracic surgeon, who does robotic cases several times a week, into its children's hospital team. Safety evidence for each age group also takes years to collect. So far the gains parents can see are small incisions, less radiation in some procedures and shorter hospital stays.

ABB's mobile YuMi concept robot carrying a rack of sample tubes in a hospital lab corridor. Photo: ABB

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