Mapping the Landscape of Neonatal Surgical Care: A Scoping Review of Current Practices and Research Gaps
DOI:
https://doi.org/10.63682/jns.v14i19S.4856Keywords:
neonatal surgery, minimally invasive surgery, ERAS protocols, robotic surgery, congenital anomalies, disparities, research gapsAbstract
Neonatal surgical care has evolved significantly over the past decade, with advancements such as minimally invasive surgery (MIS), Enhanced Recovery After Surgery (ERAS) protocols, and robotic-assisted techniques improving outcomes for congenital and acquired conditions. This scoping review synthesizes evidence from 2015 to 2025, highlighting key trends and persistent gaps. MIS demonstrates benefits, including reduced ventilator dependence (25%) and shorter hospital stays (2.8 days) for conditions like congenital diaphragmatic hernia and esophageal atresia, though challenges such as patient selection bias and technical limitations in extremely low birth weight (ELBW) infants remain. ERAS protocols show promise in reducing opioid use (62%) and accelerating enteral feeding (30%), yet inconsistent outcome definitions and limited ELBW data hinder universal adoption. Robotic surgery offers precision but raises concerns about physiological impacts (e.g., increased intracranial pressure), economic feasibility, and ethical dilemmas in resource-limited settings. Critical gaps include the lack of standardized safety thresholds, long-term neurodevelopmental data, and equitable access, particularly in low- and middle-income countries (LMICs). The review calls for multicenter collaborations, rigorous physiological studies, and targeted funding to address disparities and optimize care. Future research should prioritize technological innovations, competency-based training, and global implementation strategies to ensure safer, more effective neonatal surgical care worldwide.
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