Robot-assisted simulated cataract surgery

Bourcier, Tristan; Chammas, Jimmy; Becmeur, Pierre-Henri; Sauer, Arnaud; Gaucher, David; Liverneaux, Philippe; Marescaux, Jacques; Mutter, Didier

doi:10.1016/j.jcrs.2017.02.020

Cited by 29 publications

(29 citation statements)

References 6 publications

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“… 4 Several studies have investigated adaptation of the da Vinci Surgical System to perform ophthalmic surgery, and found that in simulated environments, it can perform corneal suturing, cataract, and pterygium surgery. 5 – 7 However, attempts at using the system in standard vitreoretinal surgery are so far unsuccessful. 8 Therefore, attention has shifted to developing a robotic surgical system specifically designed for vitreoretinal surgery.…”

mentioning

confidence: 99%

Robot-Assisted Vitreoretinal Surgery Improves Surgical Accuracy Compared With Manual Surgery

Jacobsen

Konge

Alberti

et al. 2019

Retina

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mentioning

confidence: 99%

Robot-Assisted Vitreoretinal Surgery Improves Surgical Accuracy Compared With Manual Surgery

Jacobsen

Konge

Alberti

et al. 2019

Retina

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“…We did not observe the needle or thread breakage frequently seen with da Vinci–assisted procedures using 9/0 or 10/0 nylon 9. Manipulation of the instruments around the eyeball was easy in comparison to previously experimented intraocular procedures 9,12. Access to the orbit proved very easy without helper-induced potential awkwardness, although the absence of muscle tension in our model did not require the use of a hook on the muscle.…”

Section: Discussionmentioning

confidence: 57%

“…With the exception of the measurement of the lateral rectus muscle (4 mm) for plication, resection, and recession using a caliper, no human assistance was needed for the procedures. Unlike robot-assisted simulated cataract surgery,12 no other specific microsurgical instruments had to be used in combination with the robotic system. Tissue handling (i.e., muscle, Tenon's, conjunctiva, sclera) and knot tying using 8/0 and 5/0 polyglactin were easy with Black Diamond micro forceps and micro bipolar forceps, two tools that have been specially designed for microsurgery.…”

Section: Discussionmentioning

confidence: 99%

“…The da Vinci Xi Surgical System consists of three components: a mobile instrument cart with four articulated arms, a vision cart, and a surgeon console used to control the robotic arms 12. The mobile cart contains the articulated robotic arms, three of which carry surgical instruments, and a fourth that manipulates the digital stereoscopic camera, allowing the surgeon to visualize the surgical field.…”

Section: Methodsmentioning

confidence: 99%

“…We first used the Si HD to perform robot-assisted ocular surface surgery in experimental8,9 and clinical settings 10,11. We recently demonstrated the feasibility of all of the main steps of simulated cataract surgery using the new robotic da Vinci Xi Surgical System in combination with a phacoemulsification system 12. While attempts of da Vinci–assisted posterior-segment surgeries (i.e., pars plana vitrectomy, intraocular foreign body removal) have been reported,13 to our knowledge, investigations concerning orbital or eye muscle surgery do not exist in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Simulated Strabismus Surgery

Bourcier

Chammas

Gaucher

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose This study aims to investigate the feasibility of robot-assisted simulated strabismus surgery using the new da Vinci Xi Surgical System and to report what we believe is the first use of a surgical robot in experimental eye muscle surgery. Methods Robot-assisted strabismus surgeries were performed on a strabismus eye model using the robotic da Vinci Xi Surgical System. On the lateral rectus of each eye, we performed a procedure including, successively, a 4-mm plication followed by a 4-mm recession of the muscle to end with a 4-mm resection. Operative time from conjunctival opening to closing and successful completion of the different steps with or without complications or unexpected events were assessed. Results Robot-assisted strabismus procedures were successfully performed on six eyes. The feasibility of robot-assisted simulated strabismus surgery is confirmed. The da Vinci Xi system provided the appropriate dexterity and operative field visualization necessary to perform conjunctival and Tenon's capsule opening and closing, muscle identification, suturing, desinsertion, sectioning, and resuturing. The mean duration to complete the whole procedure was 27 minutes (range, 22–35). There were no complications or unexpected intraoperative events. Conclusions Experimental robot-assisted strabismus surgery is technically feasible using the new robotic da Vinci Xi Surgical System. This is, to our knowledge, the first use of a surgical robot in ocular muscle surgery. Translational Relevance Further experimentation will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use.

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Robotic posterior capsule polishing by optical coherence tomography image guidance

Gerber

Hubschman

Tsao

2021

Robotics Computer Surgery

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Background In cataract surgery, polishing of the posterior capsule (PC) can lead to improved surgical outcomes but is currently avoided due to its high‐risk nature. This work developed a robotic system capable of performing PC polishing on ex vivo pig eyes using optical coherence tomography (OCT) guidance. Methods The lenses of five ex vivo pig eyes were extracted and a thin layer of glue deposited onto the PC. Transpupillary OCT scans of the anterior segment were used to generate a PC‐polishing trajectory. During polishing, OCT B‐scans tracked the tool tip and were displayed to the operator. Results Complete removal of the glue was accomplished in all five trials with no PC rupture reported. Conclusions The feasibility of using a robotic system guided by OCT to perform PC polishing on a biological model was demonstrated. Contributions include modelling of the PC anatomy, intraoperative OCT visualization, and automated tool‐tip motion with scheduled aspiration pressures.

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Robot-assisted simulated cataract surgery

Abstract: Experimental robot-assisted cataract surgery was technically feasible using the new robotic surgical system combined with a phacoemulsification machine.

Cited by 29 publications

References 6 publications

Robot-Assisted Vitreoretinal Surgery Improves Surgical Accuracy Compared With Manual Surgery

Robot-Assisted Vitreoretinal Surgery Improves Surgical Accuracy Compared With Manual Surgery

Robot-Assisted Simulated Strabismus Surgery

Robotic posterior capsule polishing by optical coherence tomography image guidance

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