Cooperative robot assistant for vitreoretinal microsurgery: development of the RVRMS and feasibility studies in an animal model

Chen, Yiqi; Tao, Jiwei; Su, Lingya; Li, Liang; Zhao, Shixin; Yang, Yang; Shen, Lijun

doi:10.1007/s00417-017-3656-3

Cited by 13 publications

(5 citation statements)

References 25 publications

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“…25 Two groups have developed telemanipulation systems comparable to the PSS. [26][27][28] They have shown successful application in animal studies, but they have yet to publish studies in human subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Another robot developed at the University of Leuven demonstrated that it was feasible and safe to inject ocriplasmin in the central retinal vein to treat retinal vein occlusion (RVO) in four patients using robot assistance 25 . Two groups have developed telemanipulation systems comparable to the PSS 26–28 . They have shown successful application in animal studies, but they have yet to publish studies in human subjects.…”

Section: Discussionmentioning

confidence: 99%

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Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Faridpooya

Romunde

Manning

et al. 2022

Clinical Exper Ophthalmology

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Background The aim was to explore the feasibility and safety of performing common surgical steps in epiretinal membrane (ERM) peeling using the Preceyes Surgical System (PSS). Methods In a tertiary centre, 15 pseudophakic patients with an idiopathic ERM were randomised to robot‐assistance or manual surgery in a 2:1 ratio. In the robot‐assisted group, the following steps were performed using PSS: (1) staining the internal limiting membrane (ILM), (2) removal of the dye, (3) creating an ILM flap, (4) completing the peeling, (5) holding a light pipe and (6) fluid–air exchange. Primary outcome measures were feasibility and safety. Secondary outcome measures were duration, best‐corrected visual acuity (BCVA) and central retinal thickness (CRT). Moreover, the distance travelled by the instrument during peeling was assessed using motion tracking software. Results All steps performed with PSS were feasible with no clinical adverse events or complications. The surgical time was longer in the robot‐assisted group (mean 56 min, SD = 12 vs. 24 min, SD = 5). During the study, the duration of robot‐assisted surgeries decreased from 72 to 46 min. The distance travelled by the forceps was shorter in the robot‐assisted group (mean 403 mm, SD = 186 vs. 550 mm, SD = 134). BCVA and CRT improved equally in both groups. Conclusions This is the world's first randomised controlled trial on robotic surgery for ERM. Although more time‐consuming, we found that several surgical steps were feasible with assistance of the PSS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Faridpooya

Romunde

Manning

et al. 2022

Clinical Exper Ophthalmology

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“…In addition to tremor removal and precise operation, new mechanisms or structures are explored to further improve RAMS. Snake-like robots have significant advantages to operate in the confined environment [105] , and are capturing more and more attention in recent years.…”

Section: Cooperative Controlmentioning

confidence: 99%

From Teleoperation to Autonomous Robot-assisted Microsurgery: A Survey

Zhang

Fang

et al. 2022

Mach. Intell. Res.

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Robot-assisted microsurgery (RAMS) has many benefits compared to traditional microsurgery. Microsurgical platforms with advanced control strategies, high-quality micro-imaging modalities and micro-sensing systems are worth developing to further enhance the clinical outcomes of RAMS. Within only a few decades, microsurgical robotics has evolved into a rapidly developing research field with increasing attention all over the world. Despite the appreciated benefits, significant challenges remain to be solved. In this review paper, the emerging concepts and achievements of RAMS will be presented. We introduce the development tendency of RAMS from teleoperation to autonomous systems. We highlight the upcoming new research opportunities that require joint efforts from both clinicians and engineers to pursue further outcomes for RAMS in years to come.

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“…In breast A B reconstruction using the LD flap, the incision length is within 5 cm for endoscopic or robotic surgery; however, it is 15 cm or greater for conventional surgery. The advantage of endoscopic and robotic reconstructive breast surgery is quite clear, and the benefits are believed to be comparable to those of endoscopic or robotic abdominal surgery (9,10). If the incidence of other complications in endoscopic or roboticassisted mastectomy and immediate breast reconstruction with LD flap or silicone implant is not higher than that in conventional surgery, then it can be an excellent alternative that boosts patient satisfaction by minimizing scarring and postoperative pain.…”

Section: Serratus Ventralis Tricepsmentioning

confidence: 99%

Porcine training models for endoscopic and robotic reconstructive breast surgery: a preliminary study

Lee¹,

Lee²,

Kim³

et al. 2021

Gland Surg

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Background: With recent advances in surgical techniques, minimally invasive methods for reconstructive breast surgery are being investigated. To enhance surgical proficiency through training and minimize predictable complications before human application, we conducted a preliminary experimental study of reconstructive breast surgery using a porcine model. Methods: Between February and March 2019, four 3-month-old pigs underwent a bilateral mastectomy and immediate breast reconstruction with a latissimus dorsi (LD) flap or silicone implants. After performing the mastectomy by dissecting the pectoralis profundus in the subcutaneous plane, the pig was placed in the decubitus position, and ultrasound-guided marking was used to design the LD flap. The thoracodorsal artery was marked, and a 4-cm incision was made on the midaxillary line. An additional endoscopic incision was made in the inferior margin of the LD flap; a 2-hole approach was used for endoscopic LD flap elevation. In the silicone implant model, a silicone implant (Allergan, smooth, round type, 90 cc) was placed using a single incision (4-5 cm).Results: Eight mastectomies followed by breast reconstruction with LD flap elevation or silicone implant models were performed on four pigs. Serious complications, such as active bleeding, did not occur. However, heat dispersion to the skin flap that became thinner by endoscopic dissection caused a second-degree burn in one pig.Conclusions: This preliminary study of endoscopic or robot-assisted minimally invasive reconstructive breast surgery demonstrates that a porcine training model is a highly valuable experimental model for surface anatomy verification, incision plan selection, instrument selection, operator proficiency enhancement, and complication prevention.

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Cooperative robot assistant for vitreoretinal microsurgery: development of the RVRMS and feasibility studies in an animal model

Abstract: Maneuverability, accuracy and stability of robot-assisted vitreoretinal microsurgery using the RVRMS were demonstrated in this study. Wider application research of robotic surgery and improvement of a robotic system should be continued.

Cited by 13 publications

References 25 publications

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

From Teleoperation to Autonomous Robot-assisted Microsurgery: A Survey

Porcine training models for endoscopic and robotic reconstructive breast surgery: a preliminary study

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