Robotic intercostal nerve harvest: a feasibility study in a pig model

Miyamoto, Hideaki; Serradori, T.; Mikami, Yuzuru; Selber, Jesse C.; Santelmo, Nicola; Facca, S.; Liverneaux, Philippe

doi:10.3171/2015.1.jns14603

Cited by 12 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Miyamoto et al demonstrated the robotic technique on three porcine models in 2016. 35 Three ports were used, and the surgical time for harvesting three intercostal nerves (fourth, fifth, and sixth) was 40 minutes on average. There was no conversion to open approach, and no surgical complications reported.…”

Section: Peripheral Nerve Harvest (►Table 4)mentioning

confidence: 99%

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Chen

Goh

Goh³

et al. 2021

J Reconstr Microsurg

View full text Add to dashboard Cite

Background Robotic-assisted techniques are a tremendous revolution in modern surgery, and the advantages and indications were well discussed in different specialties. However, the use of robotic technique in plastic and reconstructive surgery is still very limited, especially in the field of peripheral nerve reconstruction. This study aims to identify current clinical applications for peripheral nerve reconstruction, and to evaluate the advantages and disadvantages to establish potential uses in the future. Methods A review was conducted in the literatures from PubMed focusing on currently published robotic peripheral nerve intervention techniques. Eligible studies included related animal model, cadaveric and human studies. Reviews on robotic microsurgical technique unrelated to peripheral nerve intervention and non-English articles were excluded. The differences of wound assessment and nerve management between robotic-assisted and conventional approach were compared. Results Total 19 studies including preclinical experimental researches and clinical reports were listed and classified into brachial plexus reconstruction, peripheral nerve tumors management, peripheral nerve decompression or repair, peripheral nerve harvesting, and sympathetic trunk reconstruction. There were three animal studies, four cadaveric studies, eight clinical series, and four studies demonstrating clinical, animal, or cadaveric studies simultaneously. In total 53 clinical cases, only 20 (37.7%) cases were successfully approached with minimal invasive and intervened robotically; 17 (32.1%) cases underwent conventional approach and the nerves were intervened robotically; 12 (22.6%) cases converted to open approach but still intervened the nerve by robot; and 4 (7.5%) cases failed to approach robotically and converted to open surgery entirely. Conclusion Robotic-assisted surgery is still in the early stage in peripheral nerve surgery. We believe the use of the robotic system in this field will develop to become popular in the future, especially in the fields that need cooperation with other specialties to provide the solutions for challenging circumstances.

show abstract

Section: Peripheral Nerve Harvest (►Table 4)mentioning

confidence: 99%

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Chen

Goh

Goh³

et al. 2021

J Reconstr Microsurg

View full text Add to dashboard Cite

show abstract

“…However, thoracoscopic intercostal nerve harvest still presents difficulties because endoscopic instruments are not capable of sufficient fine movement and interfere with surgeon precision. 3 , 8 …”

Section: Discussionmentioning

confidence: 99%

“…7 The possibility of robotic intercostal nerve harvesting has already been demonstrated in a pig model. 8 The purpose of this study was to report the feasibility of robot-assisted intercostal nerve harvesting in a clinical case.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted Intercostal Nerve Harvesting: A Technical Note about the First Case in Japan

Naïto

Imashimizu

Nagura

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: Recently, surgical robotic systems have been used to perform microsurgery. Surgical robots have certain properties that make them well suited to microsurgery; for example, they possess 3-dimensional vision, which can be magnified up to 25 times; their movements are up to 5 times more precise than those of surgeons; they possess 7 degrees of wrist articulation; they do not suffer from physiologic tremors; and they can achieve ergonomic surgical positions. The purpose of this study was to report the feasibility of robot-assisted intercostal nerve harvesting in a clinical case. A healthy 57-year-old man suffered a left plexus injury. On diagnosis of clavicular brachial plexus injury, the intercostal nerve transfer to the muscular cutaneous nerve to restore elbow flexion was performed with Da Vinci Xi robot. The harvesting of intercostal nerves using the conventional open approach involves significant surgical exposure, which can lead to perioperative complications. Robot-assisted intercostal nerve harvesting might reduce postoperative pain, shorten patients’ hospital stays, lower complication rates, and produce better quality-of-life outcomes. There are many issues to be solved when performing robotic surgery on peripheral nerves in Japan. However, robot-assisted intercostal nerve harvesting was a feasible surgical procedure, and patient satisfaction was high.

show abstract

“…1 Several of these early studies used animal models to demonstrate the feasibility of the epineural and neurotrophic repairs, and nerve harvesting techniques for use in brachial plexus repair. 8 40 41 Table 2 outlines the current published literature focusing on robot-assisted brachial plexus repair in human cadavers and subjects.…”

Section: Feasibility Studiesmentioning

confidence: 99%

Robotic Nerve Surgery: Brachial Plexus

Parham,

Cole,

Yim

et al. 2023

Semin Plast Surg

View full text Add to dashboard Cite

Management of closed brachial plexus injuries has traditionally favored conservative approaches with lengthy intervals between initial injury and surgical reconstruction. The complex anatomy of this region often requires large incisions with extensive dissection. Recently, the use of robotic systems in plastic and reconstructive surgery has been increasing, and robot-assisted brachial plexus reconstruction is a novel application that is currently being explored. Current literature describing this application is primarily comprised of feasibility studies using animal and cadaver models, and literature describing use in human subjects is limited. Advantages demonstrated by these early studies include the reduction of physiologic tremor, 3D visualization of anatomical structures, and ergonomic positioning; this allows for increased surgical dexterity and the ability to perform minimally invasive microsurgical procedures within the confined anatomical spaces of the brachial plexus. Limitations revolve around inadequate instrumentation, large learning curves, and increased costs that restrict the ability to perform these complex microsurgical procedures reliably and efficiently. As companies continue to develop instrumentation specific to robot-assisted microsurgery, more extensive longitudinal studies outlining long-term costs, changes in operating time, and functional outcomes will be required before a conclusion about the utility of these systems in brachial plexus surgery can be made.

show abstract

Robotic intercostal nerve harvest: a feasibility study in a pig model

Cited by 12 publications

References 33 publications

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Robot-assisted Intercostal Nerve Harvesting: A Technical Note about the First Case in Japan

Robotic Nerve Surgery: Brachial Plexus

Contact Info

Product

Resources

About