Abstract
The introduction of robotics has led to a fundamental turning point for laparoscopic vascular surgery, which has always entailed relatively difficult manipulation with instruments and a lengthy procedure time to construct the vascular anastomosis, leading to long aortal clamping times. The robotic system removes these fundamental disadvantages of laparoscopy and opens up the possibility of expanding robot-assisted laparoscopic surgery in this area.
Vascular anastomosis can be performed robotically both on the aorta and the pelvic artery with good results and, in fact, more easily than with classical laparoscopic surgery. Another possibility is the removal of atherosclerotic masses from the lumen of the aorta or pelvic arteries that could cause narrowing of the vessels; the robotic system can thus be used for thromboendarterectomy of large vessels and subsequent patch grafting of the desobliterated arteries.
A no less interesting area of robotic surgery is abdominal aortic aneurysm surgery. In this particular case, the robot is used to do vascular anastomoses, remove thrombotic masses from the aneurysmal sac, ligate the lumbar arteries that bleed back when the sac is opened and, finally, close off the sac of the aortic aneurysm after reconstruction. All the above-described procedures end with the robotic suturing of the retroperitoneum in the abdominal cavity. An interesting application of the robotic system is in the reconstruction of visceral arteries, for example, splenic artery aneurysm surgery and renal artery reconstruction, as well as hybrid procedures.
Robotic vascular procedures can be categorised by surgical site into interventions in aortic and non-aortic region.
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Stadler, P. (2021). Robot-Assisted Vascular Surgery. In: Gharagozloo, F., Patel, V.R., Giulianotti, P.C., Poston, R., Gruessner, R., Meyer, M. (eds) Robotic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-53594-0_128
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