Robotic microsurgery: corneal transplantation

Bourges, Jean‐Louis; Hubschman, Jean‐Pierre; Burt, Ben; Culjat, Martin O.; Sd, Schwartz

doi:10.1136/bjo.2009.157594

Cited by 41 publications

(35 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the field of ophthalmic robotic surgery is still in its infancy, successful demonstrations of extraocular (corneal and scleral wounds), 13,14 anterior segment (foreign body removal and capsulorhexis), and posterior segment (25-gauge PPV) surgical tasks 15 in animal models validate ongoing research efforts towards making it a clinical reality. While most surgical subspecialties have incorporated robotic platforms into routine use, ophthalmic surgery poses a number of unique engineering challenges that have thus far limited this technology's applicability.…”

Section: Discussionmentioning

confidence: 96%

Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

Rahimy

Wilson

Tsao

et al. 2013

Eye

Self Cite

View full text Add to dashboard Cite

Purpose The aim of this study is to develop a novel robotic surgical platform, the IRISS (Intraocular Robotic Interventional and Surgical System), capable of performing both anterior and posterior segment intraocular surgery, and assess its performance in terms of range of motion, speed of motion, accuracy, and overall capacities. Patients and methods To test the feasibility of performing 'bimanual' intraocular surgical tasks using the IRISS, we defined four steps out of typical anterior (phacoemulsification) and posterior (pars plana vitrectomy (PPV)) segment surgery. Selected phacoemulsification steps included construction of a continuous curvilinear capsulorhexis and cortex removal in infusion-aspiration (I/A) mode. Vitrectomy steps consisted of performing a core PPV, followed by aspiration of the posterior hyaloid with the vitreous cutter to induce a posterior vitreous detachment (PVD) assisted with triamcinolone, and simulation of the microcannulation of a temporal retinal vein. For each evaluation, the duration and the successful completion of the task with or without complications or involuntary events was assessed. Results Intraocular procedures were successfully performed on 16 porcine eyes. Four eyes underwent creation of a round, curvilinear anterior capsulorhexis without radialization. Four eyes had I/A of lens cortical material completed without posterior capsular tear. Four eyes completed 23-gauge PPV followed by successful PVD induction without any complications. Finally, simulation of microcannulation of a temporal retinal vein was successfully achieved in four eyes without any retinal tears/perforations noted. Conclusion Robotic-assisted intraocular surgery with the IRISS may be technically feasible in humans. Further studies are pending to improve this particular surgical platform.

show abstract

Section: Discussionmentioning

confidence: 96%

Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

Rahimy

Wilson

Tsao

et al. 2013

Eye

Self Cite

View full text Add to dashboard Cite

show abstract

“…The DaVinci Si HD robotic surgical system already has been used in experimental conditions to suture corneal lacerations (porcine eyes), 14 perform penetrating keratoplasties (porcine and cadaver eyes), 15 and remove foreign bodies, lens capsules, and vitreous (porcine eyes). 16 However, procedures were longer when compared to conventional manual surgeries.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Pterygium Surgery: Feasibility Study in a Nonliving Porcine Model

Bourcier

Nardin

Sauer

et al. 2015

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

Citation: Bourcier T, Nardin M, Sauer A, et al. Robot-assisted pterygium surgery: feasibility study in a nonliving porcine model. Trans Vis Sci Tech. 2015;4(1):9, http://tvstjournal. org/doi/full/10.1167/tvst.4.1.9, doi: 10.1167/tvst.4.1.9Purpose: This study aims to investigate the feasibility of pterygium surgery using the DaVinci Si HD robotic surgical system, and to describe a porcine model for pterygium surgery and evaluate its usefulness. Methods:The pterygium models were constructed using enucleated pig eyes and cold cuts. Robotically-assisted pterygium surgeries in nonliving biological pterygium models were performed using the DaVinci Si HD robotic surgical system. Twelve models were prepared, and 12 pterygium excision and conjunctival autografts were performed.Results: The DaVinci system provided the necessary dexterity to perform delicate ocular surface surgery and robotic tools were safe for the tissues. The mean duration of the surgical procedures was 36 minutes. There were no intraoperative complications and no unexpected events.Conclusions: Robotic-assisted pterygium surgery is technically feasible for porcine eyes using the DaVinci Si HD robotic surgical system. The pterygium model that we describe could be of interest for surgical training.Translational Relevance: Little research has been done in robotic microsurgery. Animal experimentation will allow the advantages of robotic-assisted microsurgery to be identified, while underlining the improvements and innovations necessary for clinical use.

show abstract

“…Robotic open microsurgery is an unexplored yet potentially a high impact area of surgical robotics. Several researchers have used the da Vinci Surgical System from Intuitive Surgical, Inc. to perform microanastomosis operations [9]- [11], however the da Vinci system is intended for macroscale laparoscopic surgery, and lacks the appropriate tools for microsurgery. This paper explains the design and control of a novel 6-DoF robotic system for use in microsurgical operations.…”

Section: Introductionmentioning

confidence: 99%

Design and control of a parallel linkage wrist for robotic microsurgery

Değirmenci

Hammond

Gafford

et al. 2015

2015 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS)

View full text Add to dashboard Cite

Abstract-This paper presents the design and control of a teleoperated robotic system for dexterous micromanipulation tasks at the meso-scale, specifically open microsurgery. Robotic open microsurgery is an unexplored yet potentially a high impact area of surgical robotics. Microsurgical operations, such as microanastomosis of blood vessels and reattachment of nerve fibers, require high levels of manual dexterity and accuracy that surpass human capabilities. A 3-DoF robotic wrist is designed and built based on a spherical five-bar mechanism. The wrist is attached to a 3-axis commercial off-the-shelf linear stage, achieving a fully dexterous system. Design requirements are determined using motion data collected during a simulated microanastomosis operation. The wrist design is optimized to maximize workspace and manipulability. The system is teleoperated using a haptic device, and has the required bandwidth to replicate microsurgical motions. The system was successfully used in a micromanipulation task to stack 1 mm-diameter metal spheres. The micromanipulation system presented here may improve surgical outcomes during open microsurgery by offering better accuracy and dexterity to surgeons.

show abstract

Robotic microsurgery: corneal transplantation

Abstract: Teleoperated robotic penetrating keratoplasty is technically feasible in humans. Further studies are pending to implement the procedure with femtosecond laser and other automated steps.

Cited by 41 publications

References 14 publications

Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

Robot-Assisted Pterygium Surgery: Feasibility Study in a Nonliving Porcine Model

Design and control of a parallel linkage wrist for robotic microsurgery

Contact Info

Product

Resources

About