The present nationwide survey combined with a scoping review aimed to provide an overview of current paediatric robotic-assisted surgery (RAS) training practices in France, focusing on simulation tools and evaluation methods. A cross-sectional national survey was conducted among all French paediatric surgery centres with existing or upcoming RAS programmes. Answers were collected using Likert scales. A scoping review was conducted following PRISMA-ScR guidelines, screening publications from 2000 to 2025 on paediatric robotic surgery and simulation. Eighteen surgeons from 13 centres responded. Two centres had exclusive access to robotic equipment, whereas others shared platforms with adult teams. Centres reported a mean 4.2 training days per month and 37.5 RAS procedures per year. Twelve respondents reported that a dedicated paediatric RAS curriculum would be more appropriate. Fifteen (82 %) engaged in additional simulation outside their initial training. Three independent paediatric RAS simulation programmes were identified, differing in format and target audience. Only three participants used objective performance-assessment tools. The scoping review included 8 articles from 361 records. All focused on procedural robotic simulation in paediatric settings; only one addressed non-procedural interprofessional simulation. The included studies demonstrated benefits of simulation in accelerating the learning curve, improving trocar placement, and strengthening team performance. These findings support the need for structured, paediatric-specific RAS simulation programmes integrated into training pathways, supported by structured evaluation frameworks and institutional investment.

Hirschsprung disease (HD) is a congenital disorder marked by aganglionosis of intestinal nerve plexuses, leading to bowel obstruction. Determining the extent of the aganglionic segment is essential for successful surgical correction. Consequently, the extent of aganglionosis must be examined histologically. Fluorescence confocal microscopy (FCM) may serve as an alternative diagnostic modality. Using a laser to scan the unfixed specimen, it enables rapid intraoperative imaging without causing tissue alteration. This study assessed the feasibility and diagnostic accuracy of FCM in evaluating Hirschsprung disease in pediatric patients. Patients undergoing rectal biopsy, ostomy closure, or transanal endorectal pull-through (TERPT) at our center from January to August 2024 were included. Tissue samples were imaged by FCM followed by frozen section and formalin-fixed paraffin-embedded (FFPE) histology. Image quality, assessability of submucosal and myenteric plexuses, and diagnostic agreement with FFPE sections were investigated. A total of 34 samples from 8 patients were analyzed by FCM and FFPE, the 24 TERPT-derived samples were additionally analyzed by frozen section. Diagnostic agreement with FFPE was 78.5 % for FCM and 86.9 % for frozen sections (p = 0.49). Among fully assessable samples, FCM achieved 80.9 % agreement with FFPE compared to 86.4 % for frozen sections. FCM is an easy-to-implement method for identifying normal and affected bowel in HD. It is used on unfixed specimens, preserving the tissue quality. Its diagnostic accuracy is comparable to that of frozen sections in assessable samples, and it is advantageous in cases where local access to expert pathologists is limited.