Abstract
Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14). Anesthetized rats were subjected to complete transection and end-to-end anastomosis of the abdominal aorta using 10–0 prolene. Manually (n = 6) and robotic-assisted (n = 8) procedures were performed by both surgeons. A successful procedure required a patent anastomosis and no bleeding. After approximately 35 days, angiography and histopathological studies of the anastomoses were performed. Median times for robotic-assisted anastomoses were 37.5 (34.2–42.7) min for the microsurgeon and 38.5 (32.7–52) min for robotic surgeon. In the manual group, it took 17 (13.5–23) min for microsurgeon and 44 (34.5–60) min for robotic surgeon. Within the robotic-assisted group, there was a trend toward improvement in both surgeons, but greater in the microsurgeon. Robotic-assisted microvascular anastomosis in a rat model is a feasible skill acquisition exercise. By eliminating the need for a skilled microsurgical assistant, as well as, improved microsurgical technology, the robotic system may prove to be a crucial player in future microsurgical skill training.
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Supported by University of Pittsburgh Medical Center funds.
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Nicholas S. Clarke, Johnathan Price, Travis Boyd, Stefano Salizzoni, Kenton J Zehr, Alejandro Nieponice, and Pietro Bajona have no conflicts of interest.
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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. This article does not contain any studies with human participants performed by any of the authors.
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Clarke, N.S., Price, J., Boyd, T. et al. Robotic-assisted microvascular surgery: skill acquisition in a rat model. J Robotic Surg 12, 331–336 (2018). https://doi.org/10.1007/s11701-017-0738-5
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DOI: https://doi.org/10.1007/s11701-017-0738-5