Microsurgical Suture Technique: Nerve Coaptation

Khachatryan, Arbak; Tevosyan, Artur; Novoselskiy, David; Arakelyan, Gevorg; Yushkevich, Alexey; Nazarian, David Nazaretovich

doi:10.1007/978-3-030-73531-9_6

Cited by 1 publication

(1 citation statement)

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“…In epineural nerve coaptation the needle is driven through the epineurium from the outside inward. 17 This requires a precise needle placement in order to avoid damage to the fascicles. This level of precision is easy to reach with the Symani ® Surgical System that allows for ideal nerve coaptation also of the smaller nerves like the two sensory nerves (palmar branch of the median nerve and a common digital nerve) included in this series to demonstrate the usability of this machine.…”

Section: Discussionmentioning

confidence: 99%

Robotic Microsurgery in Extremity Reconstruction - Experience With a Novel Robotic System

Besmens,

Politikou,

Giovanoli

et al. 2023

Surg Innov

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Background: Robotic systems have successfully been introduced into other surgical fields in the past. First attempts with different setups are made in the field of microsurgery. The Symani® Surgical System, a flexible platform consisting of two robotic arms, features motion scaling with tremor filtration to address the demands and complexity of microsurgery. Symani’s NanoWrist Instruments are the world’s smallest, wristed surgical instruments, intended to improve a surgeon’s range of motion beyond the capability of the human hand. This combination allows surgeons to scale their hand movements while seamlessly articulating the robotic micro instruments. Purpose: We report on our experience in extremity reconstruction with this novel system. Research Design: The Symani Surgical System® was used for 6 cases of extremity reconstruction. The surgeon controlled the manipulators along with the footswitch while either sitting away from the operating table relying on 3D visualization with an exoscope or sitting at the operating table using a standard microscope. Data Collection: Microsurgical anastomoses were performed in 4 patients (3 end-to-end arterial anastomoses and one end-to-side arterial anastomosis) and nerve grafting was performed in 2 patients. Results: Microvascular anastomoses were slower vs conventional microsurgery, but all anastomoses were patent. Epineural coaptation showed proper fascicle alignment and tissue manipulation could be kept to a minimum. The platform’s motion scaling allows the surgeon to perform precise micro-movements with only minimal tissue manipulation and hard-to-reach anatomy becomes accessible more easily. Conclusions: Robotic microsurgery might gain importance in the nearer future but more data will need to be collected.

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Section: Discussionmentioning

confidence: 99%