[Artificial intelligence in pediatric surgery : Present and future]. / Künstliche Intelligenz in der Kinderchirurgie : Gegenwart und Zukunft.

BACKGROUND: Artificial intelligence, automatization and digital transformation increasingly dominate the business models of almost all enterprises. Even in medicine and medical technology, companies also no longer close their minds to this development as the advantages provided by the new ideas and processes in medicine and particularly in compact disciplines, such as pediatric surgery have occasionally been recognized. OBJECTIVE: This article gives a status quo analysis of artificial intelligence in international pediatric surgery with a discussion of future perspectives and suggestions from the authors' perspective. MATERIAL AND METHODS: Appraisal and discussion of international publications, external expert opinions and personal experiences of the authors. RESULTS: A wide spectrum of applications using artificial intelligence in surgery is internationally available. Many of these developments can also be further adapted for use in pediatric surgery. The experience using artificial intelligence for special pediatric surgical indications is currently limited to isolated cases. CONCLUSION: Disciplines such as pediatric surgery cannot disregard the trend towards the application of artificial intelligence in daily practice. In addition to the establishment of current developments, the requirements of pediatric surgery should also be taken into account. These were some of the impulses that led to the founding of the working group on digitalization of the German Association for Pediatric Surgery in September 2019.

Parental perception of treatment and medical care in children with craniosynostosis.

Surgery for craniosynostosis implies a relevant strain on the child and the parents. The development of the child's self-perception and self-confidence is mainly influenced by parental attitudes. The outcomes of 46 patients were analysed, taking into consideration parental perceptions. Parents were asked to indicate their satisfaction with the medical care and treatment provided using a questionnaire. Aesthetics were evaluated by the parents and doctors using a score (1=perfect, 5=deficient). Major surgical complications (2.2%) were reported only in the case of complex synostosis. Reoperation was necessary in 2.9% of isolated cases and 45.5% of complex cases. In general, parents were satisfied with the medical (1.3) and nursing (1.6) inpatient care. Aesthetic assessments differed between parents and surgeons, although not significantly (P=0.27). The surgeons perceived the results to be better than the parents, especially for complex synostosis (1.3 vs. 2.7). Alopecia and persistent asymmetry led to a worse perception of aesthetics. Persistent bone defects did not influence parental satisfaction. All participating parents would opt for surgery again. Surgery led to satisfactory results with a low risk of severe complications. Nevertheless, the outcomes and limits of the surgical procedure must be communicated effectively to parents, especially in complex cases, to avoid a mismatch in expectations. It would be desirable to implement structured interviews with parents during regular treatment management.