Preclinical Experience Using a New Robotic System Created for Microsurgery

Mulken, Tom J. M. van; Boymans, Clint A E M; Schols, Rutger M.; Cau, Raimondo; Schoenmakers, Ferry; Hoekstra, Lisette T.; Qiu, Shan Shan; Selber, Jesse C.; Hulst, René R W J van der

doi:10.1097/prs.0000000000004939

Cited by 63 publications

(51 citation statements)

References 23 publications

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“…This matter will certainly be discussed in future larger studies. The aforementioned finding regarding SAMS scores is in line with previous preclinical experiments 6 . It might be suggested that the use of SAMS is less appropriate for assessing robot-assisted microsurgical procedures.…”

Section: Discussionsupporting

confidence: 91%

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First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial

et al. 2020

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Advancements in reconstructive microsurgery have evolved into supermicrosurgery; connecting vessels with diameter between 0.3 and 0.8 mm for reconstruction of lymphatic flow and vascularized tissue transplantation. Supermicrosurgery is limited by the precision and dexterity of the surgeon's hands. Robot assistance can help overcome these human limitations, thereby enabling a breakthrough in supermicrosurgery. We report the first-inhuman study of robot-assisted supermicrosurgery using a dedicated microsurgical robotic platform. A prospective randomized pilot study is conducted comparing robot-assisted and manual supermicrosurgical lymphatico-venous anastomosis (LVA) in treating breast cancer-related lymphedema. We evaluate patient outcome at 1 and 3 months post surgery, duration of the surgery, and quality of the anastomosis. At 3 months, patient outcome improves. Furthermore, a steep decline in duration of time required to complete the anastomosis is observed in the robot-assisted group (33-16 min). Here, we report the feasibility of robot-assisted supermicrosurgical anastomosis in LVA, indicating promising results for the future of reconstructive supermicrosurgery.

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Section: Discussionsupporting

confidence: 91%

“…Microsurgical platform. The MUSA has been evaluated in preclinical tests of the system 6,7 . In general, the system is composed of (see Fig.…”

Section: Methodsmentioning

confidence: 99%

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First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial

et al. 2020

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“…A more detailed description of the Gen‐1 MSR is provided in a recent publication in Plastic and Reconstructive Surgery . In the aforementioned report, the feasibility of performing microvascular anastomosis using the MSR on silicone vessels has been confirmed.…”

Section: A New Master‐slave Platform For (Super) Microsurgerymentioning

confidence: 86%

“…In a previous study on silicone vessels comparing robotic‐assisted anastomoses to the conventional technique, it was shown that completing microvascular anastomosis using the MSR was feasible but required significantly more time. Nevertheless, in the robotic‐assisted group, a rapid decline in anastomosis time and improvement of the quality of the anastomosis was found …”

Section: Discussionmentioning

confidence: 98%

Robotic (super) microsurgery: Feasibility of a new master‐slave platform in an in vivo animal model and future directions

Mulken

Schols

Qiu

et al. 2018

Journal of Surgical Oncology

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Advanced microsurgical procedures are currently limited by human precision and manual dexterity. The potential of robotics in microsurgery is highlighted, including a general overview of applications of robotic assistance in microsurgery and its introduction in different surgical specialties. A new robotic platform especially designed for (super) microsurgery is presented. Results of an in vivo animal study underline its feasibility and encourage further development toward clinical studies. Future directions of robotic microsurgery are proposed.

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Fully Telemetric Robotic Microsurgery: Clinical Experience With 23 Cases

Gorji,

Wessel,

Dermietzel

et al. 2024

Microsurgery

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BackgroundRecently, 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.MethodsTwenty‐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.ResultsOverall, 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.ConclusionsOur 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.

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Preclinical Experience Using a New Robotic System Created for Microsurgery

Cited by 63 publications

References 23 publications

First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial

First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial

Robotic (super) microsurgery: Feasibility of a new master‐slave platform in an in vivo animal model and future directions

Fully Telemetric Robotic Microsurgery: Clinical Experience With 23 Cases

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