Use of Robotic Surgery in Plastic and Reconstructive Surgery: A Narrative Review.

IF 3.4 3区 医学 Q1 ENGINEERING, MULTIDISCIPLINARY
Jennifer Novo, Ishith Seth, Yi Mon, Akshay Soni, Olivia Elkington, Gianluca Marcaccini, Warren M Rozen
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引用次数: 0

Abstract

Background/objectives: Robotic systems offer enhanced precision, dexterity, and visualization, which are essential in addressing the complex nature of plastic surgery procedures. Despite widespread adoption in other surgical specialties, such as urology and gynecology, their application in plastic surgery remains underexplored. This review examines the use of robotic systems in plastic and reconstructive surgery with a focus on clinical outcomes.

Methods: A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. Search terms included ("robotic surgery" OR "surgical robots") AND ("plastic surgery" OR "reconstructive surgery"). Studies on clinical outcomes and biomimetic innovations published between 1980 and 2024 were included, while non-English, cadaver-based, and animal studies were excluded. Data were systematically extracted using Covidence and analyzed.

Results: Twenty-nine studies were identified that evaluated the clinical outcomes of robotics in areas including breast reconstruction, microsurgery, and craniofacial procedures. Robotic systems like the Da Vinci and Symani platforms offer motion scaling, tremor elimination, and enhanced depth perception. In nipple-sparing mastectomies, they reduced skin necrosis rates from 8% to 2%, while in DIEP flap reconstruction, they enabled smaller fascial incisions (2.67 ± 1.13 cm vs. 8.14 ± 1.69 cm) and faster recovery with fewer complications. In microsurgery, they achieved 100% patency for vessels under 0.3 mm and a 25.2% limb volume reduction in lymphedema patients in 3 months.

Conclusions: Robotic systems show significant promise, particularly in procedures such as nipple-sparing mastectomies, and have the potential to overcome challenges including surgeon fatigue. However, challenges such as longer operating times, high costs, and limited haptic feedback remain barriers to their adoption.

机器人手术在整形和重建手术中的应用:述评。
背景/目标:机器人系统提供了更高的精度、灵活性和可视化,这对于解决整形手术过程的复杂性至关重要。尽管在泌尿外科和妇科等其他外科专业广泛采用,但它们在整形外科中的应用仍未得到充分探索。这篇综述探讨了机器人系统在整形和重建手术中的应用,重点是临床结果。方法:通过PubMed、Embase、Scopus、Web of Science等数据库进行文献检索。搜索词包括(“机器人手术”或“手术机器人”)和(“整形手术”或“重建手术”)。纳入了1980年至2024年间发表的临床结果和仿生创新研究,而非英语、基于尸体和动物的研究被排除在外。使用covid - ence系统提取数据并进行分析。结果:29项研究评估了机器人技术在乳房重建、显微外科和颅面手术等领域的临床效果。像达芬奇和Symani平台这样的机器人系统提供运动缩放、震颤消除和增强的深度感知。在保留乳头的乳房切除术中,他们将皮肤坏死率从8%降低到2%,而在DIEP皮瓣重建中,他们使筋膜切口更小(2.67±1.13 cm对8.14±1.69 cm),恢复更快,并发症更少。在显微手术中,他们在3个月内实现了0.3 mm以下血管100%通畅,淋巴水肿患者肢体体积缩小25.2%。结论:机器人系统显示出巨大的前景,特别是在保留乳头的乳房切除术等手术中,并且有可能克服包括外科医生疲劳在内的挑战。然而,诸如较长的操作时间、高成本和有限的触觉反馈等挑战仍然是其采用的障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Biomimetics
Biomimetics Biochemistry, Genetics and Molecular Biology-Biotechnology
CiteScore
3.50
自引率
11.10%
发文量
189
审稿时长
11 weeks
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