Robotik in der plastischen Chirurgie

Grünherz, Lisanne; Gousopoulos, Epameinondas; Barbon, Carlotta; Uyulmaz, Semra; Giovanoli, Pietro; Lindenblatt, Nicole

doi:10.1007/s00104-022-01790-w

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Particularly in the case of small caliber anastomoses in coronary surgery as well as in shunt surgery and crural surgery, a eld of application could develop which should be considered more closely in the future. Signi cant technical advantages of robot-assisted 3D methods compared to open surgery are the high-precision movements of the manipulators and the 3D visualization with multiple magni cations, which enables a vascular anastomosis with su cient speed in a limited area of the human body [3,16,17]. In the nal evaluation of the system in this study, the handling of the robotic arms was rated as very direct and focused.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the MMI Symani® Robotic Microsurgical System for coronary-bypass anastomoses in a cadaveric porcine model

Rusch,

Hoffmann,

Wieker

et al. 2024

Preprint

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Objective The MMI Symani® is a recently approved robotic microsurgical system for surgical procedures in adults. The system enables the surgeon to create microanastomoses. Clinical applications so far include lymphatic vessels surgery and the creation of special flap plastics. The use of the system in coronary arteries has not yet been assessed. The aim of this preclinical study was to evaluate the applicability of the Symani® surgical system in the creation of coronary anastomoses a cadaveric porcine model.Design and Methods A total of 12 anastomoses were performed by three senior cardiovascular surgeons on the left main coronary artery of three porcine hearts. Artificial bypasses (diameter 1 mm) were performed to the left main trunk. The anastomoses were performed with the Symani® surgical system. Evaluation included procedure times and anastomosis leakage.Results All anastomoses could be successfully performed. The procedure time decreased due to the learning curve between the first anastomosis 47:28 ± 5:30 min and the last anastomosis 22:37 ± 3:25 min. The final evaluation of the anastomoses showed excellent results with low leakage. The quality of the anastomosis also improved in relation to the increasing learning curve.Conclusion The Symani® surgical system could be used to create coronary anastomoses in an acceptable time frame and without technical failures. Hence, the system appears feasible for conventional coronary surgery. Further studies in animal models are mandatory prior to clinical application.

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Section: Discussionmentioning

confidence: 96%

Evaluation of the MMI Symani® Robotic Microsurgical System for coronary-bypass anastomoses in a cadaveric porcine model

Rusch,

Hoffmann,

Wieker

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Particularly in the case of small caliber anastomoses in coronary surgery as well as in shunt surgery and crural surgery, a field of application could develop which should be considered more closely in future. Significant technical advantages of robot-assisted 3D methods compared to open surgery are the high-precision movements of the manipulators and the 3D visualization with multiple magnifications, which enables a vascular anastomosis with sufficient speed in a limited area of the human body [ 3 , 16 , 17 ]. In the final evaluation of the system in this study, the handling of the robotic arms was rated as very direct and focused.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the MMI Symani® robotic microsurgical system for coronary-bypass anastomoses in a cadaveric porcine model

Rusch,

Hoffmann,

Wieker

et al. 2024

J Robotic Surg

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The MMI Symani® is a recently approved robotic microsurgical system for surgical procedures in adults. The system enables the surgeon to create microanastomoses. Clinical applications so far include lymphatic vessels surgery and the creation of special flap plastics. The use of the system in coronary arteries has not yet been assessed. The aim of this preclinical study was to evaluate the applicability of the Symani® surgical system in the creation of coronary anastomoses a cadaveric porcine model. A total of 12 anastomoses were performed by three senior cardiovascular surgeons on the left main coronary artery of three porcine hearts. Artificial bypasses (diameter 1 mm) were performed to the left main trunk. The anastomoses were performed with the Symani® surgical system. Evaluation included procedure times and anastomosis leakage. All anastomoses could be successfully performed. The procedure time decreased due to the learning curve between the first anastomosis 47:28 ± 5:30 min and the last anastomosis 22:37 ± 3:25 min. The final evaluation of the anastomoses showed excellent results with low leakage. The quality of the anastomosis also improved in relation to the increasing learning curve. The Symani® surgical system could be used to create coronary anastomoses in an acceptable time frame and without technical failures. Hence, the system appears feasible for conventional coronary surgery. Further studies in animal models are mandatory prior to clinical application.

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“…Thus, the microsurgical toolbox of peripheral nerve surgeons could be expanded by this promising new and innovative platform. The system has so far been used in supermicrosurgery of lymphatic vessels 4 , 6 and a first patient with vascular flap anastomosis. 5 In other specialties, the DaVinci robotic surgical system (Intuitive Surgical Operations, Inc., Sunnyvale, Calif.) has been an integral surgical tool for several years.…”

Section: Discussionmentioning

confidence: 99%

Nerve Transfers Using a Dedicated Microsurgical Robotic System

Schäfer

Bahm

Beier

2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Microsurgical demands in peripheral nerve surgery are increasing. Because of the development of multiple simultaneous selective nerve transfers, the transposition of very small nerves and even single fascicles has evolved. Coaptation of these increasingly smaller structures require high skills in microsurgical techniques. In addition, the surgical situs often has very limited access and is difficult to reach with conventional microsurgical options. Robot technology, the Symani Surgical System (Medical Microinstruments, S.p.A, Calci, Pisa, Italy), was used for epineural coaptation of three donor nerves (intercostal nerves 4–6) to the long thoracic nerve and the thoracodorsal nerve as recipient nerves in a patient with brachial plexus palsy. The coaptations could be carried out successfully with the microsurgical robot technology. In combination with a high-magnification (up to 26×) 3D-exoscope, the epineural sutures could be placed very precisely and accurately. Using this new microsurgical robotic system, successful coaptation of very small nerve structures is possible. This opens possibilities for the microsurgeon to carry out even finer, more targeted and more complex nerve transfers, including procedures in anatomical regions that are difficult to reach.

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Robotik in der plastischen Chirurgie

Cited by 5 publications

References 20 publications

Evaluation of the MMI Symani® Robotic Microsurgical System for coronary-bypass anastomoses in a cadaveric porcine model

Evaluation of the MMI Symani® Robotic Microsurgical System for coronary-bypass anastomoses in a cadaveric porcine model

Evaluation of the MMI Symani® robotic microsurgical system for coronary-bypass anastomoses in a cadaveric porcine model

Nerve Transfers Using a Dedicated Microsurgical Robotic System

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