Free Tissue Transfer

  • Stacey H. BernerEmail author


The use of robotic surgical system to assist surgeons in performing microvascular anastomosis has raised important issues regarding surgical training and assessment. In conventional microsurgery, attending microsurgical training courses has become the gold standard for practical skill acquisition. Among various assessments of training, the global rating scale of objective structured assessment of technical skill (OSATS) has consistently found to be valid and reliable. The learning curve can be defined as an improvement in performance with experience and practice. This improvement tends to be more rapid at first and then decreases over time as the curve reaches a plateau. It has been demonstrated that the important aspects of learning curve including the learning plateau and the learning rate can be estimated by statistical method. Understanding the parameters of learning curve is important to establish a robotic microsurgery training program. Training and assessment for robotic-assisted microsurgery is a complex procedure, and these need to be accompanied by constructive feedback from experienced microsurgeons. The guidelines and recommendations for preceptoring robotic-assisted microsurgery will be necessary to ensure the safety of patients and surgeons while initiating a robotic microsurgery program in the future.


Donor Tissue Vascular Pedicle Global Rating Scale Free Tissue Transfer Physiological Tremor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    American Replantation Mission to China (1973) Replantation surgery in China. Plast Reconstr Surg 52:476–489CrossRefGoogle Scholar
  2. 2.
    Chen C-W, Chien Y-C, Pao Y-S (1963) Salvage of the forearm following complete traumatic amputation: report of a case. Chin Med J 82:632Google Scholar
  3. 3.
    Cobbett JR (1969) Free digital transfer: report of a case of transfer of a great toe to replace an amputated thumb. J Bone Joint Surg Br 51B:677–679Google Scholar
  4. 4.
    Cohn LH (2006) Future directions in cardiac surgery. Am Heart Hosp J 4:174–178PubMedCrossRefGoogle Scholar
  5. 5.
    Daniel RK, May JW Jr (1978) Free flaps: an overview. Clin Orthop 133:122–131PubMedGoogle Scholar
  6. 6.
    Jacobson JH, Suarez EI (1960) Microsurgery in anastomosis of small vessels. Surg Forum 11:243–245Google Scholar
  7. 7.
    Kleinert H, Kasdan M, Romero JL (1963) Small blood vessel anastomosis for salvage of severely injured upper extremity. J Bone Joint Surg Br 45A:788–796Google Scholar
  8. 8.
    Morrison WA, O’Brien BMC, MacLeod A (1978) Clinical experiences in free flap transfer. Clin Orthop 133:129–139Google Scholar
  9. 9.
    Nakayama K, Yamamoto K, Tamiya T et al (1964) Experience with free autografts of the bowel with a new venous anastomosis apparatus. Surgery 55:796–802PubMedGoogle Scholar
  10. 10.
    Selber J (2010) Transoral robotic reconstruction of oropharyngeal defects: a case series. Plast Reconstr Surg 126:1978–1987PubMedCrossRefGoogle Scholar
  11. 11.
    Taleb C, Nectoux E, Liverneaux P (2009) Limb replantation with two robots: a feasibility study in a pig model. Microsurgery 29:232–235PubMedCrossRefGoogle Scholar
  12. 12.
    Taleb C, Nectoux E, Liverneaux PA (2008) Telemicrosurgery: a feasibility study in a rat model. Chir Main 27:104–108PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryNorthwest HospitalOwings Mills, BaltimoreUSA

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