Fully Telemetric Robotic Microsurgery: Clinical Experience With 23 Cases

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-08-29 DOI:10.1002/micr.31227
Shaghayegh Gorji, Kai Wessel, Alexander Dermietzel, Matthias Aitzetmueller, Isa Wendenburg, Charalampos Varnava, Marie-Luise Klietz, Philipp Wiebringhaus, Tobias Hirsch, Maximilian Kueckelhaus
{"title":"Fully Telemetric Robotic Microsurgery: Clinical Experience With 23 Cases","authors":"Shaghayegh Gorji,&nbsp;Kai Wessel,&nbsp;Alexander Dermietzel,&nbsp;Matthias Aitzetmueller,&nbsp;Isa Wendenburg,&nbsp;Charalampos Varnava,&nbsp;Marie-Luise Klietz,&nbsp;Philipp Wiebringhaus,&nbsp;Tobias Hirsch,&nbsp;Maximilian Kueckelhaus","doi":"10.1002/micr.31227","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Recently, there is an ongoing trend in plastic surgery with robotic-assisted microsurgery and supermicrosurgery devices being developed. Combining a telemetrically controlled robotic microscope with an also telemetrically controlled microsurgery robot unlocks synergistic effects with complete disconnection of the operating surgeon from the operating field. Here, we report the first clinical free flap reconstructions using this setup.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Twenty-three surgeries were performed with the combined remote approach using the Symani Surgical System and the RoboticScope in open microsurgery procedures. Anastomosis time and ischemia time were recorded. The surgical performance for anastomoses was assessed using the modified Structured Assessment of Microsurgical Skills (SAMS) score. Subjective satisfaction was evaluated by the surgeons in comparison with conventional microsurgery. To evaluate the learning curve, the senior authors first four (first group) and last four (last group) procedures were compared.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall, flap survival was 95.7%. The average arterial anastomosis time was 36.7 ± 10.9 min. Total time of surgery was 277.7 ± 63.8 min, and ischemia time was 100.6 ± 24.9 min. Most SAMS score parameters were significantly higher in the last group of surgical procedures compared with the first operations. Subjective satisfaction was equal or better with the combined robotic-assisted approach in most categories.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our data demonstrates safety and feasibility of the use of a combined remote approach. Robotic systems for microsurgical procedures may hold promising potential for improvement of surgical quality and open up new frontiers in microsurgery.</p>\n </section>\n </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.31227","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Microsurgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/micr.31227","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Recently, there is an ongoing trend in plastic surgery with robotic-assisted microsurgery and supermicrosurgery devices being developed. Combining a telemetrically controlled robotic microscope with an also telemetrically controlled microsurgery robot unlocks synergistic effects with complete disconnection of the operating surgeon from the operating field. Here, we report the first clinical free flap reconstructions using this setup.

Methods

Twenty-three surgeries were performed with the combined remote approach using the Symani Surgical System and the RoboticScope in open microsurgery procedures. Anastomosis time and ischemia time were recorded. The surgical performance for anastomoses was assessed using the modified Structured Assessment of Microsurgical Skills (SAMS) score. Subjective satisfaction was evaluated by the surgeons in comparison with conventional microsurgery. To evaluate the learning curve, the senior authors first four (first group) and last four (last group) procedures were compared.

Results

Overall, flap survival was 95.7%. The average arterial anastomosis time was 36.7 ± 10.9 min. Total time of surgery was 277.7 ± 63.8 min, and ischemia time was 100.6 ± 24.9 min. Most SAMS score parameters were significantly higher in the last group of surgical procedures compared with the first operations. Subjective satisfaction was equal or better with the combined robotic-assisted approach in most categories.

Conclusions

Our data demonstrates safety and feasibility of the use of a combined remote approach. Robotic systems for microsurgical procedures may hold promising potential for improvement of surgical quality and open up new frontiers in microsurgery.

Abstract Image

全遥控机器人显微手术:23 例临床经验
背景 最近,整形外科领域出现了机器人辅助显微手术和超级显微手术设备的发展趋势。将遥测控制的机器人显微镜与同样由遥测控制的显微手术机器人结合使用,可以产生协同效应,使手术外科医生完全脱离手术现场。在此,我们报告了使用这种装置进行的首例临床游离皮瓣重建手术。 方法 在开放式显微外科手术中使用 Symani 手术系统和 RoboticScope 联合远程方法进行了 23 例手术。记录了吻合时间和缺血时间。吻合的手术表现采用改良的显微外科技能结构评估(SAMS)评分进行评估。与传统显微外科手术相比,外科医生对主观满意度进行了评估。为了评估学习曲线,资深作者对前四次(第一组)和后四次(最后一组)手术进行了比较。 结果 总体而言,皮瓣存活率为 95.7%。平均动脉吻合时间为(36.7 ± 10.9)分钟。手术总时间为(277.7 ± 63.8)分钟,缺血时间为(100.6 ± 24.9)分钟。与第一组手术相比,最后一组手术的大多数 SAMS 评分参数明显更高。在大多数类别中,机器人辅助联合方法的主观满意度相同或更高。 结论 我们的数据证明了使用联合远程方法的安全性和可行性。用于显微外科手术的机器人系统有望提高手术质量,开辟显微外科的新领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信