Robotically Assisted Pterygium Surgery

Abstract

Robot-assisted pterygium removal is technically feasible using the DaVinci Si HD robotic Surgical System. We report the first human case of robot-assisted pterygium surgery.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT02116062.

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

“…The FSL consequently did not require a difficult and time-consuming learning curve as shown byKuo et al 14 In addition, with the FSL, the dissection can be performed at any programmed depth 14. In an attempt to increase precision, maneuverability and ergonomics, Bourcier et al investigated the possibility of robot-assisted pterygium surgery relying on the DaVinci surgical system in a porcine model29 and recently in the first patient 30. While they found the procedure to be feasible and without complications, the surgery time (porcine model 36 minutes, patient 60.5 minutes) still limits its application in routine clinical cases.…”

Da Vinci Xi Robot–Assisted Penetrating Keratoplasty

“…Several factors, including these two improvements, led to an important decrease in operative time (43.4 minutes) when compared to a previous publication 6,7 (Bourges performed PK on cadaver eyes in 115 and 80 minutes), bringing it close to conventional manual PK duration (around 20 minutes). The use of fresh human corneas from the tissue bank that are thinner and less rigid than porcine corneas was an additional factor.…”

“…Although not specifically designed for eye surgery, the commercial availability of the Da Vinci robotic surgical system has led to many investigations of its applicability in both anterior and posterior segment eye surgery since 2006. 2,3,5–7,11,12 In the field of corneal surgery, Bourges et al 2 demonstrated the feasibility of robot-assisted PK surgery in 2009 using the Si model on enucleated porcine and cadaver eyes. However, poor visualization of the operative field, limited maneuverability of the instruments, and the absence of microsurgical instruments were considered by the authors to be hurdles to further investigations with the Da Vinci system.…”

“…The Si HD system was used to perform robot-assisted amniotic membrane transplantations and pterygium surgeries (Clinicaltrials.gov, NCT02116062). 6,7 The decision to perform robot-assisted PK is the next logical step as it is technically more difficult and the globe is widely opened after trephination. This procedure requires delicate tissue manipulation, 360-degree suturing with excellent visualization, and fast placement of corneal sutures.…”

New treatment options for pterygium

“…In an alternative approach to increasing precision, Bourcier et al investigated the use of robot-assisted (da Vinci surgical system) pterygium surgery in a porcine model [11] and recently in a patient [12]. While they found the procedure to be feasible and no complications occurred, the surgery time (porcine model: 36 min, patient: 60.5 min) still limits its application in routine clinical cases.…”