Robotic Microsurgery Optimization

Brahmbhatt, Jamin; Güdeloğlu, Ahmet; Liverneaux, Philippe; Parekattıl, Sıjo J.

doi:10.5999/aps.2014.41.3.225

Cited by 25 publications

(23 citation statements)

References 16 publications

(14 reference statements)

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“…Studies have investigated the possibilities for robot‐assisted microsurgery in surgeon training (Alrasheed, Liu, Hanasono, Butler, & Selber, ; Brahmbhatt, Gudeloglu, Liverneaux, & Parekattil, ; Gudeloglu, Brahmbhatt, & Parekattil, ; Kotsougiani et al, ; Liverneaux, Hendriks, Selber, & Parekattil, ; Selber & Alrasheed, ). Furthermore, studies have reported the utility of robot‐assisted microvascular anastomosis through animal experiments (Katz, Rosson, Taylor, & Singh, ; Knight et al, ; Liverneaux, Taleb, Nectoux, & Facca, ; Taleb, Nectoux, & Liverneaux, ).…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted microvascular anastomosis in head and neck free flap reconstruction: Preliminary experiences and results

Lai

Liu

et al. 2019

Microsurgery

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Background The da Vinci Surgical System has facilitated considerable advancements in surgery. The process and results of robot‐assisted microvascular anastomosis in real clinical situations have rarely been reported. This study presents our experience of performing robot‐assisted microvascular anastomosis in free flap reconstruction in patients with oropharyngeal cancer. Patients and methods This was a retrospective study of reconstructive operations using a free radial forearm flap for oropharyngeal defects after tumor extirpation in 15 consecutive adult patients (12 men and 3 women). In total, 17 robot‐assisted microvascular vessel anastomoses (2 arteries and 15 veins) were performed; moreover, 13 arteries and 13 veins were anastomosed using the standard operating microscope and hand‐sewing technique. Results The recipient and donor vessel diameters were 2.5 ± 0.7 and 2.1 ± 0.8 mm, respectively. The donor blood vessel diameter selected for anastomosis using da Vinci Surgical System was significantly smaller (2.1 ± 0.8 vs. 2.5 ± 0.6 mm) than that for a standard operating microscope and hand‐sewing technique (p = .021), the operating time spent (38.4 ± 10.4 vs. 28.0 ± 7.7 min) was significantly longer (p < .001). The vascular patency rate was 100%, and all flaps survived without requiring additional operation for revision. Conclusion Robotic surgical systems can facilitate vascular microanastomosis and provide a blood vessel patency rate comparable to that of a standard operating microscope and hand‐sewing technique.

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Section: Introductionmentioning

confidence: 99%

Robot‐assisted microvascular anastomosis in head and neck free flap reconstruction: Preliminary experiences and results

Lai

Liu

et al. 2019

Microsurgery

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“…Of the 68 studies included in this review, only three used a robotic system other than the daVinci ® . This dominance is beginning to be challenged and while equipment additions such as a micro-forcep is currently available for the daVinci ® robot and external companies have developed micro-doppler probes and hydrojet dissectors ( 91 ) it will be the development of further microsurgical instruments that will allow greater use of the robot in the field of plastic and reconstructive surgery. The combination of motion scaling and tremor-free instrument manipulation with new instrument design will also allow new avenues in microsurgery that have to date been too technically demanding to be explored.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Role of Robotics in Plastic and Reconstructive Surgery—From Inception to the Future

et al. 2017

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BackgroundThe use of robots in surgery has become commonplace in many specialties. In this systematic review, we report on the current uses of robotics in plastic and reconstructive surgery and looks to future roles for robotics in this arena.MethodsA systematic literature search of Medline, EMBASE, and Scopus was performed using appropriate search terms in order to identify all applications of robot-assistance in plastic and reconstructive surgery. All articles were reviewed by two authors and a qualitative synthesis performed of those articles that met the inclusion criteria. The systematic review and results were conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines.ResultsA total of 7,904 articles were identified for title and abstract review. Sixty-eight studies met the inclusion criteria. Robotic assistance in plastic and reconstructive surgery is still in its infancy, with areas such as trans-oral robotic surgery and microvascular procedures the dominant areas of interest currently. A number of benefits have been shown over conventional open surgery, such as improved access and greater dexterity; however, these must be balanced against disadvantages such as the lack of haptic feedback and cost implications.ConclusionThe feasibility of robotic plastic surgery has been demonstrated in several specific indications. As technology, knowledge, and skills in this area improve, these techniques have the potential to contribute positively to patient and provider experience and outcomes.

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“…Various tools make it possible to see beyond the mere external appearance, revealing functional properties. [1] Some systems enable to form an additional image that reveals microcirculation and therefore make it easier to distinguish cancerous tissue from healthy tissue by the injection of a small amount of indocyanine green, a dye tracer visualized by an infrared system. This noninvasive technique also verifies the effectiveness of a vascular anastomosis.…”

Section: Functionalized Visionmentioning

confidence: 99%

Endoscopic telemicrosurgery or minimally invasive robotically-assisted microsurgery for peripheral nerve repair

et al. 2015

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Microsurgery comprises a variety of surgical procedures such as neurovascular anastomoses, performed under optical magnification and with fine instrumentation. While refinements have been made since its advent in the 1960s, robotics offers the potential for major technological advancement. Endoscopic telemicrosurgery is minimally invasive, robotically-assisted microsurgery. This technique removes some limitations of conventional microsurgery and enhances visual and manual dexterity. Vision is enhanced through greater magnification, three-dimensionality, and functionalization, all through an endoscopic view. Manual dexterity is improved by suppression of physiological tremor and tremor filtration, while permitting useful enhancement of movement amplitudes and tactile feedback forces. Furthermore, better endoscopic ergonomics, new hand tools and the ability for multi-manual and remote work, confer a distinct advantage. Endoscopic telemicrosurgery is already in clinical use. Some of the advantages above are incorporated into the DaVinci ® robot, that is, used in brachial plexus surgery. Conventional brachial plexus surgery requires large incisions for exploration and neurotization, with its attending risks of unsightly scars, prolonged hospital stay, sepsis, and perineural adhesions that interfere with nerve regrowth. Endoscopic telemicrosurgery limits the incisions and these risks, with minimal compromise. Endoscopic telemicrosurgery, through the amplification of human capabilities may pave the way for a major advancement in the microsurgical field.

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Robotic Microsurgery Optimization

Cited by 25 publications

References 16 publications

Robot‐assisted microvascular anastomosis in head and neck free flap reconstruction: Preliminary experiences and results

Robot‐assisted microvascular anastomosis in head and neck free flap reconstruction: Preliminary experiences and results

A Systematic Review of the Role of Robotics in Plastic and Reconstructive Surgery—From Inception to the Future

Endoscopic telemicrosurgery or minimally invasive robotically-assisted microsurgery for peripheral nerve repair

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